Finding a lump in your breast is always a source of concern. However, not all breast lumps are cancer. 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, but they are more common in cisgender women between the ages of 35 and 55. Their exact cause is unknown, but the growths result from cells in the duct that grow 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?
An intraductal papilloma is not breast cancer. The papillomas are benign breast lumps formed from clusters of abnormally growing cells. Both the lumps and the cells are benign. Some experts describe these lumps 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, but they can be a sign that you may be more likely to get breast cancer later. You can talk to your doctor about managing your breast cancer risk.
Intraductal Papilloma Symptoms
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.
Intraductal Papilloma Diagnosis
If you think 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 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 to see where to place the needle.
Surgical biopsy. If no lump is present, 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. If you only have one papilloma, your doctor might choose the watch-and-wait approach. As long as there are no changes, you might not need surgery. While the papilloma isn't cancerous, there is a risk that the cells in it could change and become malignant (cancerous) over time. If your doctor does see changes, removing the papilloma prevents it from turning into cancer later.
If you have multiple papillomas, surgery is much more likely.
The surgery to remove a duct and papilloma is similar to a lumpectomy 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, the duct and papilloma will be examined in a lab to rule out cancer. There are rare cases in which 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.
Can intraductal papillomas go away?
Intraductal papillomas do not go away on their own. But if you only have a few and they don’t affect your duct, your doctor may choose to monitor you — rather than opt for immediate surgery — unless something changes.
Intraductal Papilloma Prevention
Some people are at higher risk for intraductal papilloma. Your risk is higher if you’ve been exposed to estrogen for a long period, you have a family history of intraductal papillomas, or you’re perimenopausal. But there is no known way to prevent them from developing.
Intraductal Papilloma and Breastfeeding
If you're breastfeeding, you may develop intraductal papilloma symptoms, which include bloody discharge from your nipple. Unlike the bleeding from cracked or raw nipples, which is common in the early days and weeks of breastfeeding, this bloody discharge will come from your nipple and is usually only on one side.
If you see blood or discharge coming from your nipple, speak with your doctor as soon as possible. It’s best not to nurse from that side until you find out what is going on. To prevent engorgement, you can continue to gently pump from that breast and then toss the milk. This will also help ensure the milk supply for when you can resume nursing on that side.
Takeaways
An intraductal papilloma is a small, usually painless, noncancerous growth that can appear in a milk duct in your breast. You could get just one or several papillomas. Although your doctor may choose to watch for any changes, surgery for papillomas is common. That's because these cells could change and develop into cancer at some point, although this is rare.
Intraductal Papilloma FAQs
Do intraductal papillomas need to be removed?
If you only have one, your doctor might recommend watching and waiting to see if there are any changes, rather than removing it. However, if you have several, surgery is usually recommended. If left untreated, intraductal papillomas could lead to complications or signal a more serious issue.
Is an intraductal papilloma high risk?
Intraductal papillomas are called “high-risk precursor lesions.” This means that they could go on to become cancerous. This is why they should be watched or removed.
Can a breast papilloma go away?
Intraductal papillomas, which appear in the breast, don’t go away on their own.
