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Intraductal Papilloma of the Breast

Breast Intraductal Papillomatosis


Presentation

  • This benign neoplasm presented as a 15-cm breast mass, enlarging over a 2-year period.[ncbi.nlm.nih.gov]
Axillary Lymphadenopathy
  • No axillary lymphadenopathy was found at the time of surgery. Whereas no changes were seen in the patient's breast on ultrasound or mammography during follow-up, an enlarged lymph node became palpable in the left axilla 10 years later.[diagnosticpathology.biomedcentral.com]
  • There was no axillary lymphadenopathy. No family history of carcinoma breast was present. Fine needle aspiration smears showed benign cellular changes with apocrine metaplasia. Biopsy from an area adjacent to nipple showed intraductal papilloma.[ijpmonline.org]
  • In addition, the breast cancer group more commonly showed AVS (P   0.008), axillary lymphadenopathy (P   0.001), and prepectoral edema (P   0.002).[journals.plos.org]
Camping
  • I’m in the ‘not a disease’ camp. Lots of things are variable in people; Extra thick hair, smooth or blemished skin are examples. I think of a small solitary papilloma in a duct like that.[breast-cancer.ca]
  • Well versed with hospital based surgical camps where high volume, high quality surgical care can be delivered in a cost effective manner to large population.[jyotirmay.com]
Plethora
  • Nevertheless, a great deal of controversy surrounds their diagnosis, as intraductal papillomas can be associated with a plethora of histological types and various characteristics.[news-medical.net]
Nausea
  • But then, the nausea started. Either from the anesthesia, or the headache or a combination, I had to head quickly to the bathroom.[coachdebbieruns.com]
  • Lapatinib exhibited activity against trastuzumab-refractory MBC and showed an acceptable adverse event profile such as transient mild rash, diarrhea and nausea.[jstage.jst.go.jp]
Heart Disease
  • However, being heavy during childhood and the teen years is not advised as it increases the risk of heart disease and many other health conditions in adulthood [ 36 ]. These topics are under active study.[ww5.komen.org]
  • There was no difference noted in the incidence of ischemic heart disease for women taking tamoxifen.[benhhoc.com]
Nipple Discharge
  • MRI detected two of these "small lumenal mass" papillomas in patients with abnormal nipple discharge even when galactography was unsuccessful. Seven papillomas were irregular enhancing masses detected in patients without nipple discharge.[ncbi.nlm.nih.gov]
  • Nipple Discharge and Breast Papilloma A papilloma will usually involve a nipple discharge , sometimes of serous fluid but sometimes with blood as well. ( About half of the time the nipple discharge contains blood).[breast-cancer.ca]
Bloody Nipple Discharge
  • Abstract Intraductal papillary tumors of the breast exhibit bloody nipple discharge with often no evidence of a palpable tumor, making discrimination between benign and malignant lesions sometimes difficult for pathologists and surgeons.[ncbi.nlm.nih.gov]
  • They are a common cause of clear or bloody nipple discharge, especially when it comes from only one breast. They may be felt as a small lump behind or next to the nipple. Sometimes they cause pain.[cancer.org]
  • When one of these papillomas breaks a duct, it can cause a little clear or bloody nipple discharge. If you have multiple papillomas, they usually occur deeper inside your breast, and can't easily be felt.[verywell.com]
Bloody Nipple Discharge
  • Abstract Intraductal papillary tumors of the breast exhibit bloody nipple discharge with often no evidence of a palpable tumor, making discrimination between benign and malignant lesions sometimes difficult for pathologists and surgeons.[ncbi.nlm.nih.gov]
  • They are a common cause of clear or bloody nipple discharge, especially when it comes from only one breast. They may be felt as a small lump behind or next to the nipple. Sometimes they cause pain.[cancer.org]
  • When one of these papillomas breaks a duct, it can cause a little clear or bloody nipple discharge. If you have multiple papillomas, they usually occur deeper inside your breast, and can't easily be felt.[verywell.com]
Breast Mass
  • This benign neoplasm presented as a 15-cm breast mass, enlarging over a 2-year period.[ncbi.nlm.nih.gov]
  • Many breast masses found accidently. Epidemiology of Breast Masses in Adolescents The estimated prevalence of breast masses in adolescents is around 3.2 %.[lecturio.com]
  • These are performed by inserting a needle into a breast mass and removing cells or tissues, for further examination.[dovemed.com]
Bleeding from the Nipple
  • […] tumor in a milk duct of the breast, occasionally marked by bleeding from the nipple.[medical-dictionary.thefreedictionary.com]
  • Intraductal papillomas may need to be surgically removed if they become painful or cause bleeding from the nipple. In order to remove the intraductal papilloma, a small incision is made along the edge of the areola.[breasthealthandhealing.org]

Workup

  • Abstract Fine-needle aspiration cytology (FNAC) is being employed with increasing frequency for the pre-operative diagnostic workup of breast lesions.[ncbi.nlm.nih.gov]
  • Mammography is not recommended in the diagnostic workup for breast masses in adolescents due to the relatively higher density of the adolescent breast compared to the adult breast.[lecturio.com]
  • Evaluation Requires workup including excisional biopsy of affected duct must rule out intraductal papillary carcinoma mammography Non-blood discharge galactorrhea order TSH, prolactin, and beta-hCG levels Treatment Surgical excisional biopsy of affected[medbullets.com]
  • Workup is the same as in a nonpregnant woman. The standard preoperative staging workup is performed. Laboratory values such as alkaline phosphatase may be elevated during pregnancy.[benhhoc.com]
  • One small intraductal papilloma was evident on the left in the mastectomy specimen that was occult to imaging and clinical workup. There was no pathologic evidence of invasive carcinoma in either breast.[appliedradiology.com]

Treatment

  • Excision of the nipple can disrupt or abolish the ability to breastfeed after treatment, so patients should discuss the effects of nipple excision with a physician before treatment.[livestrong.com]
  • THE AIM OF THE STUDY: To assess the value of the mammography-guided and ultrasound-guided vacuum-assisted core biopsy in the diagnosis and treatment of intraductal papillomas of breast and to answer the question if mammotome biopsy allows to avoid surgery[ncbi.nlm.nih.gov]
  • Treatment The usual treatment is surgery to remove the papilloma and the part of the duct it’s in.[cancer.org]
  • Treatment and management of breast papilloma Solitary papillomas; if there are no functional complications or atypical features, will often just be left alone.[breast-cancer.ca]
  • PubMed Google Scholar Ganaraj A, Petrek JA: Diagnosis and treatment of cancer arising in ectopic breast tissue. Clin Rev. 2002, 58: 566-570.[diagnosticpathology.biomedcentral.com]

Prognosis

  • Best prognosis . 6-7 Grade 2 tumor ( moderately differentiated ). Medium prognosis. 8-9 Grade 3 tumor ( poorly differentiated ). Worst prognosis.[en.wikipedia.org]
  • Careful evaluation outside the papillary lesion is required since the prognosis is driven by concurrent DCIS or a clear cut invasive component there. Encapsulated papillary carcinomas carry an excellent prognosis.[dentisty.org]
  • Evaluation Requires workup including excisional biopsy of affected duct must rule out intraductal papillary carcinoma mammography Non-blood discharge galactorrhea order TSH, prolactin, and beta-hCG levels Treatment Surgical excisional biopsy of affected duct Prognosis[medbullets.com]
  • Treatment and prognosis Most centers treat solitary intraductal papillomas with surgical excision, even after benign biopsy, to exclude components of atypia or neoplasia.[radiopaedia.org]

Etiology

  • Validation of HPVs role in the etiology of breast cancer/papilloma, require further studies to understand whether the HPVs are episomal or integrated during the tumorigenesis. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-05-05.[cancerres.aacrjournals.org]
  • DCIS (component of regular intraductal papilloma is still recognizable in the lesion) Epidemiology Common; mean age 48 years Sites Large lactiferous ducts: central papilloma (more common in male breast) Smaller peripheral ducts: peripheral papilloma Etiology[pathologyoutlines.com]
  • (Etiology) The exact cause of development of Intraductal Papilloma of Breast is currently not clearly understood. Studies have shown that such tumors may be caused by hormonal influence Certain gene mutations have also been reported in the tumors.[dovemed.com]
  • Some have suggested a traumatic etiology, especially in the case of cranial fasciitis (birth trauma). Patients are most commonly between 20 and 40 years of age and usually present with a rapidly growing mass, usually smaller than 5 cm.[roentgenrayreader.blogspot.com]
  • Benign disease is the etiology in the majority of cases. However, pain may be associated with cancer in up to 10% of patients.[benhhoc.com]

Epidemiology

  • RENAL CELL CARCINOMA: THE 2012 ISUP VANCOUVER CLASSIFICATION David Grignon MD, Indiana University, Indianapolis, IN RENAL CELL CARCINOMA EPIDEMIOLOGY Siegel et al.[docplayer.net]
  • Epidemiology Peak Incidence : age 35-55 years old (mean age 48 years old) IV.[fpnotebook.com]
  • […] component and raise suspicion of malignancy Papilloma with atypia (atypical intraductal papilloma): papilloma with ADH Papilloma with DCIS: intraductal papilloma with DCIS (component of regular intraductal papilloma is still recognizable in the lesion) Epidemiology[pathologyoutlines.com]
  • To estimate relative risks, we compared the number of observed breast cancers with the number expected on the basis of the rates of breast cancer in the Iowa Surveillance, Epidemiology, and End Results registry.[nejm.org]
  • Epidemiology of Breast Masses in Adolescents The estimated prevalence of breast masses in adolescents is around 3.2 %. The most common type of breast masses in adolescents is a fibroadenoma and is diagnosed in up to 95 % of the cases.[lecturio.com]
Sex distribution
Age distribution

Pathophysiology

  • Breast Cancer Classification Breast Cancer Symptoms Breast Cancer Causes Breast Cancer Pathophysiology[news-medical.net]
  • Pathophysiology Mechanism of growth appears to be proliferative fibrocystic epithelial hyperplasia Broad-based or pedunculated polypoid epithelial growth of size 2-3 mm and within Lactation duct Localized within 1 cm of nipple in 90% of cases V.[fpnotebook.com]

Prevention

  • Familiarity with this entity is important in preventing misdiagnosis of malignancy.[ncbi.nlm.nih.gov]
  • Prevention There is no known way to prevent intraductal papilloma. Breast self-exams and screening mammograms can help detect the disease early. Images References Davidson NE. Breast cancer and benign breast disorders.[m.ufhealth.org]
  • Prevention There is no known way to prevent intraductal papilloma. Breast self-exams and screening mammograms can help detect the disease early. References Davidson NE. Breast cancer and benign breast disorders. In: Goldman L, Schafer AI, eds.[mountsinai.org]
  • In 2014, the Intradialytic Hypotension Prevention Pathway algorithm was formally registered with the organization's Centre for Clinical Effectiveness and introduced into the network's five dialysis centers.[medical-dictionary.thefreedictionary.com]

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