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Pathology of Breast Cancer
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
Intraductal papilloma is a benign papuliform proliferation of ductal epithelium which is characterized by a prominent fibrovascular core lined by a two-cell ductal epithelial/myoepithelial layer (Fig. 18) [80,81]. The size varies from a few mil limeters to a few centimeters in diameter. Mammography following galactography helps to identify and localize small intraductal papillomas. The distinction between intraductal papilloma and intraductal carcinoma is difficult and may require demonstration of myoepithelial cells by immunostaining for muscle-specific actin [82,83]. It is best to recommend surgical biopsy of the entire lesion if there is any doubt in the exact nature of a papillary lesion [25].
Breast
Published in Joseph Kovi, Hung Dinh Duong, Frozen Section In Surgical Pathology: An Atlas, 2019
Joseph Kovi, M.D. Hung Dinh Duong
Papillary carcinoma with or without invasion must be differentiated from intraductal papilloma. Patients with invasive papillary carcinoma are 50 years old on the average. The average age of patients with benign papilloma is 39 years.49 Palpable breast mass was noted by Kraus and Neubecker 49 in 27 (82%) of the 33 patients with intraductal papillomas. All patients with papillary carcinoma had a palpable mass in that same series. Only 34% of patients with papillary carcinoma presented with nipple discharge; in about 80% of patients the predominant symptom of intraductal papilloma is bloody nipple discharge.
Conditions
Published in Sarah Bekaert, Women's Health, 2018
An intraductal papilloma is a benign wart-like lump that forms within a duct just behind the areola. There may be a small lump and/or a discharge of clear, sticky or bloodstained fluid from the nipple. Intraductal papillomas can be present in both breasts at the same time, and are sometimes discovered following breast surgery. Women nearing the menopause are more likely to have a single intraductal papilloma, whereas younger women often have more than one.
Assessment and management of B3 breast lesions with atypia: a focused review
Published in Climacteric, 2020
M. U. Ugurlu, T. Yoldemir, B. M. Gulluoglu
Papillary lesions (PL) comprise a range of proliferative breast lesions from intraductal papilloma with/without atypia to intraductal papilloma with ADH, DCIS, encapsulated papillary carcinoma, and invasive papillary carcinoma. Intraductal papillomas without atypia are benign lesions of fibrovascular cores lined by epithelium and myoepithelium, most often solitary, located in the central breast, but can also occur peripherally2. PL may present with serous/bloody discharge or with palpable/radiologic mass formation. The major challenge for the pathologist in interpreting CNB or VAB material is to rule out the presence of atypia, and the diagnosis can be difficult especially with CNB, since CNB generally offers small fragments in comparison to VAB. The distinction is important because in the case of PL without atypia on CNB or VAB, no further treatment is recommended when the biopsy is sufficiently representative, in small lesions, and when no discordance to imaging is present11,29,56.
Diagnosis and Treatment of 75 Patients with Idiopathic Lobular Granulomatous Mastitis
Published in Journal of Investigative Surgery, 2019
Patient demographic and baseline variables are shown in Table 1. All patients were multiparous and their mean age was 35.9 ± 10.0 (21–61) years. Sixty-nine (92%) patients were in childbearing age and 98.7% (74/75) of patients had breastfeeding experience, with median lactation duration of 12 months (range 1 month to 5 years). The weaning period ranged from 5 months to 31 years (median 22 months) and 73 patients were diagnosed as IGLM after weaning. One patient received mastectomy 6 months ago, and postoperative pathological diagnosis confirmed intraductal papilloma of the breast. In addition, 4 patients had a history of mastitis. The remaining patients did not have a history of breast surgery or trauma. All patients did not use contraceptives, sex hormones or antidepressants and did not suffer from skin erythema, arthritis and immune system disease.
Ultrasound-guided percutaneous microwave ablation of central intraductal papilloma: a prospective pilot study
Published in International Journal of Hyperthermia, 2019
Jie Yu, Han Wu, Xian-Wei Meng, Meng-Juan Mu, Jian-Ping Dou, Muneeb Ahmed, Ping Liang
Intraductal papilloma (IDP) of the breast is a benign tumor, affecting 2–3% of the female population. IDP is the most common pathological finding in 30–50-year-old women who have pathological nipple discharge, accounting for 40–70% of cases [1–3]. IDP is characterized by the presence of a proliferating arborescent fibrovascular core lined with an outer epithelial layer and an inner myoepithelial layer [3]. IDP can be divided into central papilloma (large-duct papilloma), commonly involving a single lesion near the nipple, and peripheral papilloma (small-duct papilloma), commonly involving multiple lesions and with a higher risk of cancer evolution [4]. For IDP with associated atypia or malignancy diagnosed using core needle biopsy, the recommended treatment is excision. However, the treatment choice for IDP without core biopsy-diagnosed atypia or malignancy remains controversial [5]. With the desire for minimal invasive therapy and better cosmetic outcome, apart from traditional excision, alternative techniques have been used for IDP treatment, such as image-guided vacuum-assisted biopsy (VAB) [6], providing a minimally invasive modality for these lesions.