Breast duct Papilloma

[rodarich65]

My mother is 66, South-Italian extraction, only history of family breast cancer is her paternal aunt, diagnosed at 88.  Mom has had annual mammo/ultrasnd since 1989 following abnormality in upper-left quad,left breast, decided non-threatening and now smaller. She has had only one event of spontaneous bleeding - 1 month ago - pin-***** sized droplet, wine red colour. Upon squeezing,another droplet: darker, brown. She was referred to a surgeon and he examined her and squeezed a sample and visually identified it as blood, thereby suspecting Pappiloma. New mammo and ultrasound revealed only sludge in one duct suggesting the Pap'ma broke? Surgeon recommends excision of ducts, to confirm as Papilloma and biopsy, but left timetable to us. We have a follow-up consult/exam in 4 months; and regular exams every 6 mos and mammo/ultrsnd yearly now necessary.

Papilloma is classed as precancerous, though not always becoming malignant. Also patients remain at higher risk for future breast cancer, ducts excision notwithdstanding.   Can this be safely monitored rather than undergo surgery - and how best, or must this come out?

Is there an alternative to ducts excision surgery? For example, can an MRI rule out cancer now and is regular monitoring a safe alternative.

Questions I in my mind: Will the Papilloma definitely grow back? Is there a notion of timeframe? How often do Papillomas become themselves cancerous? How often does other breast cancer occur in papilloma patients? Can you answer these and/or suggest any links/resources for further information on Papilloma? Thank you.

[CCF-RN,MSN-rf]

Dear Rodarich65:  An intraductal papilloma is a wartlike growth that occurs within the duct that may cause the duct to bleed.  It is not a precancerous condition nor does it increase the risk for developing cancer.  Most often a surgeon will remove the duct to be certain it is a papilloma.  If this is confirmed with surgery, it will likely be the end of the problem.  Although a papilloma is a common cause of a bloody nipple discharge, other conditions such as DCIS may present this way and may not be visible on MRI.

[rodarich65]

Thank you very much, particularly for responding so quickly. My comments about Papilloma being precancerous, etc. were what we understood from the surgeon/specialist, who spoke mostly about Papilloma and fibro-cystic tissues - so I especially appreciate that clarification.  Thinking back, I don't remember his speaking about DCIS (ductal cancer in situ) specifically, other than saying that in 35 years of practice he has only very rarely seen this sort of bleeding symptom turn out to be cancer.  I'll finish reading the posts on DCIS and again thank you for this great service.  I think a well informed patient who more fully understands his/her condition(s) and options makes for higher quality, less stressful and more satisfying health care all round.  Richard in Toronto.

[nomax2]

2 weeks ago I underwent a breast biopsy.  It was determined that I have several intraductal papillomas.  Before this procedure the discharge was clear and sticky.  The discharge is now brown and bloody.  I don't see a surgeon for nearly 3 weeks and was wondering if this might be normal after a biopsy.  Thanks.

[photoglover]

A related discussion, Blood from Nipple after ductectomy was started.