Finding a lump in your breast is always a source of anxiety. Not all breast lumps are cancer, however, which is good news. There are multiple types of benign lumps such as cysts, fibrous tissue, and intraductal papillomas.
An intraductal papilloma is a small growth inside one of the milk ducts in your breast. The growths are benign (not cancerous) and usually painless, but they can cause unusual nipple discharge. You may have them in one or both breasts. You might have just one growth in a single milk duct, or there can be several papillomas in multiple ducts.
What Causes Intraductal Papilloma?
Both men and women can get intraductal papillomas. They are more common in cis women between the ages of 35 and 55. The exact cause of them is unknown, but the growths result from cells in the duct growing faster than normal. The overgrowth of cells forms a small lump.
Experts believe that your risk of intraductal papilloma may be affected by:
- Family history of intraductal papilloma
- Hormone replacement therapy
- Hormonal contraceptive use
- Lifetime estrogen exposure
Is Intraductal Papilloma Cancerous?
Intraductal papillon is not breast cancer. The papillomas are benign breast lumps formed from clusters of cells that are growing abnormally. The lumps and the cells are benign. Some experts describe them as similar to warts.
In most cases, a single intraductal papilloma is not a risk factor for getting cancer later. The papilloma may be present at the same time as other breast changes, such as atypical cells in the ducts or other parts of the breasts. These changes can show an increased cancer risk.
People who have multiple papillomas have a small increase in their breast cancer risk. The papillomas themselves are not cancer. They can be a sign that you may be more prone to breast cancer later. You can talk to your doctor about managing your breast cancer risk.
Symptoms of Intraductal Papilloma
Many intraductal papillomas have no symptoms at all. The most common symptom is unusual nipple discharge. The fluid leaking from your nipples might be clear or bloody. You may feel a small lump behind your nipple, or your doctor might feel it during an exam.
Testing for Intraductal Papilloma
If you suspect you have an intraductal papilloma, your doctor will order tests to be sure.
Imaging. You may need a mammogram or ultrasound to find the papilloma and see how large it is. If those tests don't show the papilloma, you might need an MRI (magnetic resonance imaging) of your breasts.
Needle biopsy. Your doctor might also suggest a biopsy to rule out the possibility of cancer. If the papilloma causes a lump that your doctor can feel, they can do a needle biopsy. They will insert a needle into the tissue of the papilloma and draw out a sample for testing. They may use ultrasound so they can see where to place the needle.
Surgical biopsy. If there is not a lump, you might need a surgical biopsy. Your doctor will need to make an incision in your breast to remove tissue for testing. With either type of biopsy, your doctor will tell you how to prepare for the procedure.
Treatment for Intraductal Papilloma
Your doctor will probably recommend surgery to remove the papilloma and the duct in which it is formed. While the papilloma isn't cancerous, there is a risk that the cells in it could change and become malignant (cancerous) over time. Removing the papilloma eliminates the possibility that it could turn into cancer later.
The surgery to remove a duct and papilloma is similar to the lumpectomy procedure for removing a tumor. You will probably need general anesthesia for the operation. Once you are asleep, your doctor will make a small cut in your breast and use surgical tools to remove the duct. They will then close the incision using surgical glue or stitches.
After surgery, you may have pain for several days. Your doctor will give you instructions to care for the wound. You might need to take antibiotics to prevent infection after the operation.
After surgery, your doctor may do more testing on the duct and papilloma to completely rule out cancer. There are rare cases that those tests may reveal cancer even if your doctor did not suspect it. If that happens, your doctor will work with you to develop a breast cancer treatment plan.
If you have unexplained nipple discharge or have a lump in your breast, talk to your doctor. You should have tests to check for intraductal papilloma and rule out breast cancer.
