Abstract
BackgroundBreast intraductal papilloma is a heterogeneous group. The aim of the study is to investigate the intraductal breast papilloma and its coexisting lesions retrospectively in real‐world practice.MethodsWe retrospectively identified 4450 intraductal breast papilloma and its coexisting lesions.ResultsAbout 18.36% of intraductal papilloma coexisted with malignant lesions of the breast, 37.33% coexisted with atypia hyperplasia (AH), 25.24% coexisted with benign lesions, and only 19.10% coexisted without concomitant lesions. In addition, 36.80% of intraductal breast papilloma had nipple discharge, 51.46% had a palpable breast mass, and 16.45% had both nipple discharge and a palpable breast mass. About 28.18% experienced discomfort or were asymptomatic. Furthermore, 98.99% had ultrasound abnormalities, and 53.06% had intraductal hypoechogenicity upon ultrasound. 31.89% had mammographic distortion, and 14.45% had microcalcification upon mammography. Intraductal breast papilloma with malignancy had significant correlations with clinical manifestations.ConclusionCoexisting malignancy was also related to ultrasound abnormality (BIRADS 4C and 5), mammographic distortion, and microcalcification upon mammography but was not related to the intraductal hypoechoic upon ultrasound. Coexisting atypical hyperplasia correlated with nipple discharge but not palpable mass, mammographic distortion, or intraductal hypoechoic upon ultrasound. The coexisting AH was also related to abnormality upon ultrasound or microcalcification compared with the benign lesions. The intraductal papilloma coexists with malignancy or AH accounted for more than 50%, and the clinical information on papilloma and its coexisting lesions is nonspecific. We recommended surgical treatment for benign intraductal papillary lesions.
Highlights
An intraductal papilloma is a benign, or noncancerous breast tumor which originated from the epithelium of mammary ducts that forms in a milk duct
Coexisting atypical hyperplasia correlated with nipple discharge but not palpable mass, mammographic distortion or intraductal hypoechoic upon ultrasound
The coexisting atypia hyperplasia was related to abnormality upon ultrasound or microcalcification compared with the benign lesions
Summary
An intraductal papilloma is a benign, or noncancerous breast tumor which originated from the epithelium of mammary ducts that forms in a milk duct. The symptoms, clinical signs and supersonical appearances widely differ. These lesions may present clinically either as ultrasound abnormalities or palpable breast masses, with or without nipple discharge. Central papilloma originates from large ducts, often accompanied by pathological nipple discharge, while most peripheral papillomas occur in TDLU, involving small ducts. The management of benign intraductal papilloma remains controversial because of its nonspecific clinical findings, as well as its association with surrounding malignant pathology [5,6,7]. Our study aimed to address intraductal breast papilloma and its coexisting lesions. The aim of this study is to investigate the intraductal breast papilloma and its coexisting lesions retrospectively in real-world practice
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