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Intraductal Papilloma

In-duct Pepper-llama
Picmonic
Intraductal papillomas are a type of breast tumor which often presents as bloody nipple discharge in 20-40 year old patients. There are two variants, central (which occurs under the nipple) and peripheral, which has higher malignancy potential. These tumors can be too small to palpate and require galactogram biopsy to be ruled out.
8 KEY FACTS
PRESENTATION
Bloody nipple discharge
Bloody discharge from nipple

Typically in cases of intraductal papilloma, patients present with bloody nipple discharge. Intraductal papilloma is the most common cause of bloody nipple discharge in women between the ages 20-40.

Women 20-40 years old
Women with 20 dollar bill and 40 oz

This breast disease most commonly presents in women between the ages 20-40.

MECHANISM
Small tumor in lactiferous ducts
Small tumor released in Milk-fur Ducts

Intraductal papilloma is a small tumor which grows in the lactiferous ducts of the breast. There are two types as noted below.

Occurs Centrally
Central duct

The first type is centrally occurring and develops beneath the nipple. This is the most common type. These are typically solitary and often arise in the period nearing menopause. Central tumors are more likely to have bloody nipple discharge than are peripheral ones.

Occurs Peripherally
Peripheral duct

The second type occurs peripherally in the breast and usually arises as multiple papillomas. This type is often found in younger women.

Increased malignancy
Up-arrow Malignant-man

Peripherally occuring intraductal papillomas have a higher malignancy potential than the central variant.

DIAGNOSIS
Too Small to Palpate
Small Paws

These masses are often too small to palpate, and necessitate further studies to adequately diagnose or rule out.

Galactogram biopsy
Milk-galaxy biopsy-needle

Because these tumors are too small to palpate, biopsy is guided via galactogram. This is a specialized form of imaging used to view the breast ducts to help rule out (or in) this tumor. MRI is also useful for detecting tumors for biopsy.

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