Learning objectives
The learning objectives are to review the imaging findings of papillomatosis of breast (BP),
including the mammographic,
sonographic and magnetic resonance imaging findings,
and to discuss the risk of development of cancer and management possibilities.
Background
Intraductal papillomas of breast are papillary configuration of the mammary epitheliumand are benign lesions.
It includes solitary papillomas,
juvenile papillomatosis and BP.
BP occurs in approximately 10% of cases of intraductal papillomas.
It is defined as a minimum of five clearly separate papillomas within a localized segment of breast tissue.
In BP,
tumours occur deeper and more peripheral within the breast than solitary papillomas.
Clinically,
they often present as palpable masses and the nipple discharge is rare.
They are more frequently seen in younger women...
Findings and procedure details
Mammographic findings of papillomatosis can be variable and range from round to oval or lobulated well-circumscribed or spiculated masses.
Within the masses,
calcifications may be seen.
It can also present as focal microcalcifications or clusters of nodules.
Breast ductography has considerable limitations in BP,
especially in detecting lesions that do not completely obstruct the ductal lumen,
and in detecting multiple lesions in the same duct,
so it is not commonly used in BP.
On sonography BP,
lesions are usually slightly hypoechoic,
round,
oval,
or lobulated...
Conclusion
BP is more frequently associated with hyperplasia,
atypia,
DCIS,
sclerosing adenosis,
radial scar,
and in rare cases with invasive carcinoma.
Radiological diagnosis is challenging since the imaging findings can be nonspecific in all imaging modalities and the actual size of the lesion and extent of the disease may be larger than that appreciated by imaging findings.
The risk of developing cancer is increased in BP,
so the patients should be kept under annual review.
References
Harjit K,
Willsher PC,
Bennett M,
Jackson LR,
Metcalf C,
Saunders CM.
Multiple papillomas of the breast: is current management adequate?Breast.2006;15(6):777–781.
MacGrogan G,
Moinfar F,
Raju U.
Intraductal papillary neoplasms.
In: Tavassoli FA,
Devilee P,
editors.World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Breast and Female Genital Organs.Lyon,
France: IARC; 2003.
pp.
76–88.
Guray M,
Sahin AA.
Benign breast diseases: classification,
diagnosis,
and management.Oncologist.2006;11(5):435–449.
Al Sarakbi W,
Worku D,
Escobar PF,
Mokbel K.
Breast papillomas: current management with a focus...