Intraductal Papilloma

Question 1

Define intraductal papilloma.

Answer 1

Intraductal papillomas of the breast are benign lesions.

Question 2

What are the two types of intraductal papilloma?

Answer 2

Central

Peripheral

Question 3

What is the central type of intraductal papilloma?

Answer 3

The central type develops near the nipple. They are usually solitary and often arise in the period nearing menopause.

Question 4

What is the peripheral type of intraductal papilloma?

Answer 4

On the other hand, the peripheral type are often multiple papillomas arising at the peripheral breasts, and are usually found in younger women. The peripheral type is associated with a higher risk of malignancy.

Question 5

Explain the aetiology/risk factors of intraductal papilloma.

Answer 5

PMHx of breast cancer or a high-risk breast lesion.
Genetic factors, such as a mutation of the BRCA1 or BRCA2 gene.
Childhood radiation exposure to the chest.

Question 6

Summarise the epidemiology of intraductal papilloma.

Answer 6

There is an incidence of 2-3%. It is the most common cause of bloody nipple discharge in women aged 20-40 years old.

Question 7

Recognise the presenting symptoms of intraductal papilloma. Recognise the signs of intraductal papilloma on physical examination.

Answer 7

Bloody nipple discharge
Breast enlargement
Lumps
Pain or discomfort

Question 8

Identify appropriate investigations for intraductal papilloma and interpret the results.

Answer 8

Galactogram
FNA
Mammogram/Breast USS