What Is Intraductal Papilloma?
Intraductal papilloma is a breast lump. Breast lumps have traditionally been a source of anxiety for females, but the best part is that not all breast lumps or lesions are cancerous. Some commonly found lesions in the breast include cysts, fibrous tissue, other types of benign, malignant lesions, and intraductal papillomas. Intraductal papillomas are benign, painless, warty growth in the mammary ducts of the breast. These papillomas can lead to abnormal discharge from the nipple and can affect either or both breasts. Papillomas can be multiple or a single lump involving a single milk duct. Intraductal papillomas can affect both men and women, females are most commonly affected, and these lesions are probably diagnosed amongst females in the age group between 35 to 55.
What Are the Types of Intraductal Papilloma?
Intraductal papillomas can be classified as:
Solitary Papillomas: These are single large tumors or lesions found in large mammary ducts near nipples; these lesions are commonly responsible for clear or bloody discharge from the nipple and can be painful.
Multiple Papillomas: When papillomas are found in large numbers, in groups away from the nipple, termed multiple papillomas, these papillomas are less likely to cause any discharge.
What Are the Causes of Intraductal Papilloma?
The exact cause of the intraductal papilloma is not known, but it has been observed that abnormal proliferation and cell growth develop lumps in the ducts. These papillomas are commonly seen among females aged 35 to 55 years. Research suggests that the following individuals are at a higher risk of getting intraductal papilloma:
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Family history of intraductal papilloma.
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Hormone replacement therapy.
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Hormonal contraceptive use.
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Lifetime estrogen exposure.
What Are the Symptoms of Intraductal Papilloma?
Intraductal papillomas are generally asymptomatic but can have abnormal fluid discharge from the nipple. The discharge can be pale yellow or bloody in color; small or large lumps can be palpable around the breast. Sometimes, the patient might complain of pain or be diagnosed accidentally during a breast examination.
Below mentioned are some of the signs of which when an observed doctor should be informed:
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A new lump is felt for more than a week.
An area of the breast feels or is noticeably different from the surrounding area.
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A lump is persistent even after menstruation.
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A lump changes or grows larger.
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Bruises appear on the breast for no apparent reason.
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The color of the breast skin changes, or the skin peels off abnormally.
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Nipples become inverted, which was previously normal.
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Any abnormal discharge was observed from the nipples.
How Is Intraductal Papilloma Diagnosed?
Various diagnostic tests are used along with the clinical examination to confirm the diagnosis of the condition; some of the diagnostic tests used are as mentioned below:
Imaging: Breast ultrasound, mammogram, magnetic resonance imaging (MRI), a ductogram, or galactogram are some of the imaging techniques that help in diagnosing intraductal papillomas.
Needle Biopsy: This is the procedure carried out to extract the sample from the lump; when the lump is palpable, the doctor uses a needle to draw fluid for examination.
Surgical Biopsy: A surgical procedure where a mass of tissue from the lesion is removed and sent to the lab for further examination to determine the lesion's type, cell structure, and malignant potential. This is an invasive procedure that is carried out under local anesthesia.
What Are the Possible Causes of Breast Lumps?
Some of the causes that can present with breast lumps are as follows:
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Milk cysts generally occur in mothers during breastfeeding periods due to the formation of lumps of milk in the milk ducts, which are painful.
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Fibrocystic breasts.
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Fibroadenoma.
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Hamartoma.
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Intraductal papilloma.
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Mastitis.
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Malignant tumors of the breast.
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Injury.
How Is Intraductal Papilloma Treated?
Treatment of intraductal papilloma depends on the symptoms presented, the size of the lesion, the type of discharge, and the diagnostic reports. As papillomas can be benign and asymptomatic, causing no discomfort and can be painful and have a relation with other serious findings. Depending on the type of papilloma doctor can advise the treatment. Removal of the lesion surgically is generally recommended in severe cases where the lump and the affected duct are excised. This procedure is called lumpectomy or removing the lump and is carried out under general anesthesia to prevent pain and any discomfort during surgery. Surgical excision of the lesion prevents the further risk of malignant transformation of the papillomatous cells; after surgery, the excised mass is sent to the lab for evaluation. If any malignancy is found, further care and treatment are planned accordingly to prevent its metastasis. After surgery, patients might experience pain for a few weeks. Analgesics and antibiotics are prescribed to prevent infection and reduce the intensity of the pain.
Other procedures that can be required depending on the diagnosis include:
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Mastectomy refers to removing the breast tissue.
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Chemotherapy uses drugs to fight or destroy cancer.
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Radiation is a treatment that uses radioactive rays or materials to fight cancer.
If the condition is diagnosed in the initial stages, it might not require any invasive procedure and can be treated with the help of antibiotics and analgesics. Therefore, it is very important to know and examine the body regularly so that any changes are not left unnoticed. As it is best said, prevention is better than cure. Self-awareness is the only key that can prevent or help in the early detection of the lesions if present; hence any change observed must be informed to the doctor.
Conclusion:
Intraductal papilloma is a benign, warty growth observed in the breast, these papillomas can be observed in males and females, but females are most commonly affected. These lesions are generally asymptomatic but, in some cases, can have pale yellow or bloody discharge and can be painful. In other cases, they are diagnosed during a routine examination. The diagnosis is confirmed after carrying out diagnostic tests like MRI, biopsy, fine needle aspiration cytology (FNAC), etc. Mild asymptomatic cases can be cured with the help of antibiotics. Still, severe cases require surgical removal of the mass. Intraductal papillomas or breast lumps can be prevented by regular examination of the body and informing the doctor if any changes are observed.
