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What Are Intraductal Papillomas?

Medically Reviewed by Dan Brennan, MD on June 12, 2021

An intraductal papilloma is a benign (noncancerous) tumor that grows in your breast ducts. Your breast tissue naturally changes as you get older, but sometimes the tissue changes abnormally or grows quickly. This type of change can sometimes cause a tumor, like an intraductal papilloma.

Understanding Intraductal Papillomas

If you have one intraductal papilloma, it usually grows just behind your nipple. If you have more than one intraductal papilloma, they develop around your breast instead. 

There are some things that increase your risk for having intraductal papillomas, including: 

  • Using hormonal contraceptives (such as oral birth control pills)
  • Receiving hormone replacement therapy
  • Being exposed to a high amount of estrogen
  • Family history

‌This type of tumor doesn’t usually have any noticeable symptoms. However, it does raise your risk of developing breast cancer. 

Intraductal papillomas are considered to be precancerous. They make up around 10% of benign breast growths and fewer than 1% of all malignant (cancerous) breast growths. They are most common in women between 35 and 55 years old. 

Symptoms of Intraductal Papillomas

Because intraductal papillomas develop when your breast cells grow quickly, they can look similar to another condition called ductal hyperplasia (also called epithelial hyperplasia or proliferative breast disease). While intraductal papillomas are tumors, hyperplasia is not. Hyperplasia happens when the lining of your milk ducts or glands produces too many cells.‌

Ductal hyperplasia develops in the tubes inside your breast, while lobular hyperplasia develops in your milk glands. Neither is more common than the other, and both raise your risk for breast cancer.

The two conditions may seem similar, but they aren't. Unlike intraductal papillomas, hyperplasia doesn’t look like a lump.‌

When you have an intraductal papilloma, you may not notice any symptoms. If you do have symptoms, they may include:‌

  • A thick nipple discharge that is white or yellow. It usually comes from only one nipple but may come from both, depending on how many tumors you have.
  • Tenderness around your nipples, areola, and breast that is sensitive to touch even if you don’t have pain. 
  • A lump that you can feel under your skin‌.
  • An inverted nipple, or a nipple that points inward (if the tumor is below your nipple).‌

In rare cases, the rapid expansion of your breast tissue leads to an infection. If you think that you might have an infection, talk to your doctor right away to prevent permanent tissue damage. This is especially important if:

  • You have redness that lasts a long time or is unusual
  • Your pain is getting worse
  • You have a fever
  • Your breast is swollen
  • Any of your symptoms are spreading

Diagnosing Intraductal Papillomas

Mammograms. Because intraductal papillomas may not cause symptoms, your doctor might find one during your regular breast exam. If you or your doctor notice a lump on your breast that you think is unusual, your doctor may send you for a mammogram.

A mammogram is a breast exam performed in a special imaging machine. A technician places your breast on an imaging plate, and another plate presses down from the top. The plates flatten your breast and take an x-ray image. The process is repeated with your other breast, and your doctor reviews the results.

Intraductal papillomas may look like abnormal growths on a mammogram, while hyperplasia often looks like normal tissue. A mammogram can help your doctor determine which kind of growth you have.‌‌

Biopsy. If your breast tissue is thick enough to cause a hard lump under the skin, it may look like breast cancer on a mammogram or other imaging test. Your doctor may want to take a small sample of breast tissue from the affected area for a biopsy.

During a biopsy, your doctor inserts a small needle into the lump to take out a tissue sample. In rare cases, your doctor may need to cut open your breast to take a sample of the tissue. This type of procedure has a longer healing time.

Because intraductal papillomas may be cancerous, biopsy results are important. They help your doctor tell if you have cancer and how advanced your cancer is. If your tumor is benign, your doctor will be able to tell from the biopsy results.

Treating Intraductal Papillomas

Breast surgery is the only way to treat intraductal papillomas. Your doctor will need to remove the tumor before it spreads to more tissue. If your doctor finds more than one tumor, they will likely remove them all during one surgery.‌

Even if you had a biopsy before your breast tumor was removed, your doctor will likely send a tissue sample for another biopsy to ensure that they removed all of the affected breast tissue.

WebMD Medical Reference

Sources

SOURCES:‌

American Cancer Society: “Hyperplasia of the Breast (Ductal or Lobular).”

Breastcancer.org: “Mammogram Results: Breast Imaging Reporting and Database System (BI-RADS).”

Medscape: “Pathology of Small, Peripheral Intraductal Papillomas.”

StatPearls: "Intraductal Papilloma." 

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