Intraductal papilloma

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Intraductal papilloma
Intraductal papilloma histopathology (3) p63.JPG
Histopathology of intraductal papilloma of the breast by excisional biopsy. Immunostaining for p63 protein.
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Intraductal papillomas of the breast are benign lesions with an incidence of approximately 2-3% in humans. [1] They result from abnormal proliferation of the epithelial cells lining the breast ducts. [2]

Contents

Two types of intraductal papillomas are generally distinguished. The central type develops near the nipple. They are usually solitary and often arise in the years nearing menopause. On the other hand, the peripheral type are often multiple papillomas arising at the peripheral ducts, and are usually found in younger women. The peripheral type are associated with a higher risk of malignancy. [3]

They are the most common cause of bloody nipple discharge in women age 20-40 and generally do not show up on mammography due to their small size. They may be detectable on ultrasound. A galactogram is the most definitive test but is somewhat invasive.

The masses are often too small to be palpated or felt. A galactogram is therefore necessary to diagnose the type of lesion.

Excision is sometimes performed. [4] Microdochectomy/microdochotomy (removal of a breast duct) is the treatment of choice.

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Papilloma Medical condition

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Papillary hidradenoma Medical condition

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Lobular carcinoma in situ Medical condition

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Breast mass Localized swellings that feel different from the surrounding tissue

A breast mass, also known as a breast lump, is a localized swelling that feel different from the surrounding tissue. Breast pain, nipple discharge, or skin changes may be present. Concerning findings include masses that are hard, do not move easily, are of an irregular shape, or are firmly attached to surrounding tissue.

Nipple adenoma Medical condition

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Breast biopsy

A breast biopsy is usually done after a suspicious lesion is discovered on either mammography or ultrasound to get tissue for pathological diagnosis. Several methods for a breast biopsy now exist. The most appropriate method of biopsy for a patient depends upon a variety of factors, including the size, location, appearance and characteristics of the abnormality. The different types of breast biopsies include fine-needle aspiration (FNA), vacuum-assisted biopsy, core needle biopsy, and surgical excision biopsy. Breast biopsies can be done under ultrasound, MRI or a stereotactic biopsy technique. Vacuum assisted biopsies are typically done using stereotactic techniques when the suspicious lesion can only be seen on mammography. On average, 5-10 biopsies of a suspicious breast lesion will lead to the diagnosis of one case of breast cancer.

Galactography or ductography is a medical diagnostic procedure for viewing the milk ducts. The procedure involves the radiography of the ducts after injection of a radiopaque substance into the duct system. The procedure is used for investigating the pathology of nipple discharge.

Breast imaging

In medicine, breast imaging is a sub-speciality of diagnostic radiology that involves imaging of the breasts for screening or diagnostic purposes. There are various methods of breast imaging using a variety of technologies as described in detail below. Traditional screening and diagnostic mammography uses x-ray technology. Breast tomosynthesis is a new digital mammography technique that produces 3D images of the breast using x-rays. Xeromammography and Galactography also use x-ray technology and are also used infrequently in the detection of breast cancer. Breast ultrasound is another technology employed in diagnosis & screening and specifically can help differentiate between fluid filled and solid lumps that can help determine if cancerous. Breast MRI is, yet, another technology reserved for high-risk patients and can help determine the extent of cancer if diagnosed. Lastly, scintimammography is used in a subgroup of patients who have abnormal mammograms or whose screening is not reliable on the basis of using traditional mammography or ultrasound.

Papillomatosis of the breast (PB) is a rare, benign, epitheliosis-like lesion, i.e. an overgrowth of the cells lining the ducts of glands that resembles a papilla or nipple-like nodule/tumor. PB tumors develop in the apocrine glands of the breast. PB is also termed juvenile papillomatosis because of its frequent occurrence in younger women and Swiss cheese disease because of its microscopic appearance. Rarely, PB has also been diagnosed in very young, adolescent, and adult males.

References

  1. Cilotti A, Bagnolesi P, Napoli V, Lencioni R, Bartolozzi C (November 1991). "[Solitary intraductal papilloma of the breast. An echographic study of 12 cases]". La Radiologia Medica (in Italian). 82 (5): 617–20. PMID   1780459.
  2. Li A, Kirk L (January 2020). "Intraductal Papilloma". StatPearls: Internet. PMID   30137824.
  3. Tarallo, V; Canepari, E; Bortolotto, C (June 2012). "Intraductal papilloma of the breast: A case report". Journal of Ultrasound. 15 (2): 99–101. doi:10.1016/j.jus.2012.03.002. PMC   3558092 . PMID   23396758.
  4. Ahmadiyeh N, Stoleru MA, Raza S, Lester SC, Golshan M (August 2009). "Management of intraductal papillomas of the breast: an analysis of 129 cases and their outcome". Annals of Surgical Oncology. 16 (8): 2264–9. doi:10.1245/s10434-009-0534-1. PMID   19484312. S2CID   21938897.