Breast reduction with ductal papillomas present

[goins3]

Before my doctor would do a breast reduction, he sent me to a breast surgeon because I had a breast discharge for over 6 years.  A test was done on the discharge and showed abnormal cells. A ductogram was performed and I have two papillomas in my breast.  The papillomas are non-cancerous.  The doctor wants me to come back in three months to have the fluid rechecked. Should I go ahead with the reduction with the papilloma present? The breast surgeon said it was ok to go ahead.  I am unsure.

[CCF-RN,MSN-rf]

Dear goins3:  If the condition is not malignant, there is no reason not to proceed.  Papillomas are not premalignant, so this does not necessarily pose any future risk.  The bigger question is what was abnormal about the cells and how will this be evaluated in the future?  Since a breast reduction will change the anatomy of the breast, a ductogram may not be possible in the future.  Our recommendation is to have a thorough discussion with a breast specialist who can discuss risks and benefits as they pertain specifically to you.

[surgeon]

If the only info about the papillomas is based on testing the fluid, and the xray, it's not absolutely certain they are benign, although it is certainly likely that they are. So, as with any process in the breast that doesn't have an absolute diagnosis, the options are careful followup or a biopsy. If your plastic surgeon thinks the reduction will not affect at all the area where the papillomata are located, then followup theoretically will not be adveresely affected. If followup would include repeat ductogram, it would seem quite possible it would be made more difficult by the surgery. Without knowing the details it's not possible to make a recommendation that is meaningful; nevertheless, I'd give strong consideration to biopsy of the papillomata before the reduction if there's any question at all about post op distortion of the area.