Type:
Educational Exhibit
Keywords:
Breast, Oncology, Management, MR, Ultrasound, Mammography, Biopsy, Contrast agent-intravenous, Diagnostic procedure, Multidisciplinary cancer care, Neoplasia
Authors:
M. Bradač; Maribor/SI
DOI:
10.1594/ecr2018/C-2534
Background
Intraductal papillomas of breast are papillary configuration of the mammary epithelium and 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 and are often bilateral.
Papillomas in BP arise in the terminal ductal lobular units and are more frequently associated with hyperplasia,
atypia,
DCIS,
sclerosing adenosis,
and radial scar.
Multifocality,
extent of lesions,
associated risk factors and patients personal preferences all together contribute to the decision on the type of surgery,
such as breast conservative surgery or mastectomy.
BP is related to higher risk of developing breast cancer, recurrences after surgical treatment are more common and,
if patients are treated conservatively,
they should be kept under annual review.
However,
as the risk of developing cancer is small,
long term and affecting both breasts,
long-term follow-up is more appropriate than the prophylactic mastectomy.