Intraductal papilloma
Intraductal papilloma is a benign breast condition. This means it is not cancer.
What is intraductal papilloma?
A papilloma is a growth a bit like a wart. These can grow inside the ducts of the breast, often near to the nipple.
Usually, intraductal papillomas are between 1 and 2cm in size. Sometimes they can be slightly larger. Often there is only one papilloma which can be easily removed. Sometimes there are many of them. This is called papillomatosis.
Papillomatosis is less common than a single intraductal papilloma. It happens in around 1 in 10 (around 10%) of people with intraductal papilloma. Papillomatosis can happen in both breasts. It tends to develop further up the breast near the milk producing lobules.
Papilloma is not a cancer and is very unlikely to develop into a cancer. But the cells of the papilloma should be examined under the microscope. The sample of cells is taken by a 
. Sometimes, it can be difficult to tell under the microscope if the biopsy cells contain cancer. This might be because the sample is too small. In this situation, your surgeon will talk with you about removing a larger area to check.
There is a rare type of breast cancer called papillary breast cancer. This is different from intraductal papilloma, even though the names are similar.
Who gets intraductal papilloma?
Intraductal papillomas can occur at any age. They usually happen as the breast ages and changes, and they are most common in women between 35 and 55 years old.
Multiple papillomas tend to happen in younger, women.
Does intraductal papilloma increase the risk of getting breast cancer?
A single intraductal papilloma is not likely to increase your risk of developing breast cancer. People with multiple papillomas (papillomatosis) have a slightly increased risk of breast cancer. Because of this, you might have more regular checks from your doctor.
You may have certain changes in the cells of intraductal papilloma. These changes are called atypical hyperplasia. Atypical hyperplasia can increase your risk of developing breast cancer in the future.
Atypical hyperplasia
Intraductal papilloma can be associated with another condition called atypical hyperplasia. Atypical cells mean that the cells are not entirely normal. Hyperplasia means the cells in the breast increase in number.
Normal cells go through quite a few changes before they become cancerous. The cells may not necessarily become cancer cells. The cells might not change further. Or they may die off or go back to normal.
If there are any atypical cells in the papilloma when the biopsy is examined, they will usually be seen under the microscope.
Multiple papillomas are more likely to be associated with atypical hyperplasia, but this is not always the case. You will need to talk to your doctor about your biopsy result to make sure.
Symptoms of intraductal papilloma
You might notice any of the following:
- a breast lump
- a clear or bloodstained discharge coming from the nipple
- pain or discomfort (although this is less common)
Many people with an intraductal papilloma do not have any symptoms.
Diagnosing intraductal papilloma
Intraductal papillomas are sometimes found at routine breast screening examinations when you have a mammogram, or following breast surgery. They can also be found if you visit your GP with symptoms.
If you have breast symptoms, your GP may refer you to a breast clinic. This might be a one-stop clinic where you have several tests during one visit (a triple assessment).
The tests can diagnose breast cancer and other breast conditions. You might have an examination of your breast and an ultrasound scan and sometimes a breast x-ray (mammogram). If these tests show an abnormal area, a doctor or nurse takes a sample of tissue (a biopsy).
Treatment
Your team will talk with you about the best treatment to for you.
The usual treatment is removing the papilloma.
You are likely to have a vacuum assisted excision (VAE) if the cells look normal under the microscope. Vacuum assisted excision uses a needle inserted into your breast. Attached to the needle is a vacuum device that sucks out the papilloma.
Your doctor might suggest removing more of the area if there are any abnormal looking cells under the microscope (atypical hyperplasia). This is called a surgical excision.
Your team will give you more information on your options. Ask them any questions you might have.
Breast cancer risk factors
Get more information on the possible risk factors for breast cancer.
Breast cancer protective factors
Some factors can help to reduce the risk of breast cancer in general. These include:
- being physically active
- having a healthy diet and limiting the amount of alcohol you have
