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intraductal papilloma

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Intraductal papillomas are localised areas of epithelial proliferation within large mammary or lactiferous ducts. The lesions may occur singly or as part of the multiple intraductal papillomatosis syndrome which has an increased risk of malignancy.

Patient's are generally premenopausal and present with nipple discharge and bleeding. A small, painful subareolar nodule is present in 30% of cases.

The condition must be distinguished from Paget's disease, adenoma of the nipple, and carcinoma. A mammogram is indicated. The injection of contrast - ductography - may identify the papilloma as a filling defect.

Treatment is by surgical excision of the affected segment of breast tissue - microdochectomy.

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