J Breast Cancer.  2010 Mar;13(1):31-36. 10.4048/jbc.2010.13.1.31.

Clinicopathologic Review of the Intraductal Papilloma of Breast

• Ra YM
• Sohn JS
• Kim KW
• Lee JU
• Park HD
• Choi IS
• Choi WJ
• Yoon DS

• KMID: 2286557
• DOI: http://doi.org/10.4048/jbc.2010.13.1.31

Abstract

PURPOSE
Intraductal papilloma of the breast (IDP) is the most common causes of nipple discharge and it is often a solitary, centrally located tumor that most commonly occurs in the fifth and sixth decades of life. There have been many conflicting reports on the malignant potential of IDP.
METHODS
From February 2003 to November 2008, we operated 161 patients who were diagnosed with IDP at Konyang University Hospital. A retrospective review of all the pathologic reports and the corresponding radiological reports was undertaken.
RESULTS
The mean age of the patients was 43.23 years (SD, +/-10.1). Eighty-three (51.6%) had nipple discharge, 37 (44.6%) had bloody discharge and 46 (55.4%) had yellowish serous discharge. Twenty-four had a mass and 2 had both bloody discharge and a mass. Radiologic significant findings were shown on 20 mammography exams, 71 ductography exams and 157 breast ultrasound exams. Onehundred forty-four (89.4%) patients with IDP or papillomatosis had surrounding pathologic lesions in the operated specimen according to the final pathology, 107 (66.5%) had fibrocystic change, 26 (16.1%) had fibroadenoma, 30 (18.6%) had atypical ductal hyperplasia (ADH), 11 (6.8%) had carcinoma in situ and 4 (2.5%) had invasive ductal carcinoma. During the follow up, 7 patients (4.3%) developed recurrent IDP, 3 patients developed ADH and 5 patients developed carcinoma in situ (4 patients had ductal carcinoma in situ and 1 patient had lobular carcinoma in situ).
CONCLUSION
Intraductal papilloma should be closely followed up due to its malignant potential and the surrounding breast tissue with IDP should be carefully evaluated due to the high rate of developing other precancerous lesions.

Keyword

Atypical ductal hyperplasia; Ductal carcinoma in situ; Intraductal papilloma; Invasive dductal carcinoma; Precancerous conditions

MeSH Terms

Breast
Carcinoma in Situ
Carcinoma, Ductal
Carcinoma, Intraductal, Noninfiltrating
Carcinoma, Lobular
Fibroadenoma
Follow-Up Studies
Humans
Hyperplasia
Mammography
Nipples
Papilloma
Papilloma, Intraductal
Precancerous Conditions
Retrospective Studies

Figure

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  Figure 1 Microscopic findings of Intraductal pailloma (IDP) with surrounding pathologic lesions. (A) IDP with fibrocystic change (FCC) (H&E stain, ×12.5). (B) IDP with atypical ductal hyperplasia (ADH) (H&E stain, ×12.5) and ADH (H&E stain, ×400). (C) IDP with ductal carcinoma in situ (DCIS) (H&E stain, ×12.5) and DCIS (H&E stain, ×200). (D) IDP with Lobular carcinoma in situ (LCIS) (H&E stain, ×12.5) and LCIS (H&E stain, ×200).

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