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Central Intraductal Papilloma

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An intraductal papilloma is a benign tumor that grows inside the breast duct. A central intraductal papilloma develops in a large duct just below the nipple, usually as a single growth, although it’s possible to have more than one. (You may see the term “solitary papilloma” used.) A central papilloma with normal-looking cells (nothing atypical) doesn’t increase the risk of a future breast cancer.

The papilloma is typically a small, tan-pink growth — usually less than 1 centimeter (cm) — although it can grow up to 5 or 6 cm. It usually occurs in women between the ages of 30 and 50. Sometimes it’s picked up on a screening mammogram. It also may be diagnosed after you experience symptoms such as a lump and/or unusual nipple discharge. This discharge is often bloody or clear and happens spontaneously — that is, it appears without any pressure on the breast. (This is different from discharge that is yellowish or green or that appears when compressing the breast.) Under a microscope, a papilloma appears to be made up of finger-like projections.

Your doctor will perform minor surgery to remove the papilloma itself or the duct with the papilloma inside it. Often a small cut can be made along the circular edge of the areola (the darker skin surrounding the nipple). A pathologist (a doctor who examines cell samples) can then examine the papilloma to make sure all of the cells are normal, confirming you are at no increased risk of breast cancer.

Infrequently, a central papilloma may contain abnormal-looking cells that resemble atypical ductal hyperplasia (which carries a moderate increase in the risk of breast cancer) or even low-grade ductal carcinoma in situ.

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