Intraductal papilloma is commonly observed in parous women, with peak incidence occurring between the ages of 40 and 50. Approximately 75% of cases involve the ampulla of the large lactiferous ducts, while papillomas affecting the medium and small ducts are often located in the peripheral areas of the breast. The tumors are pedunculated and villous, containing numerous thin-walled blood vessels, making them prone to bleeding. The malignancy rate is approximately 6–8%, with papillomas originating in the small ducts having a higher risk of malignant transformation.
Clinical Manifestations
Nipple discharge is the most common symptom of this condition. Patients often notice abnormal nipple discharge when it stains their undergarments. The discharge can be yellow, brown, or bloodstained. The tumors are usually small and difficult to palpate. In rare cases where the tumor is larger, applying pressure over the tumor area may result in nipple discharge from the corresponding duct.
Treatment
Surgical excision is the primary treatment. Preoperative ductoscopy can be used to identify the affected duct and the location of the tumor. A localization wire may be placed during the ductoscopy to mark the diseased duct, or methylene blue can be injected into the discharging duct during surgery to facilitate localization. Surgery involves complete removal of the affected ductal system. Routine histopathological examination is performed, and, in cases of malignancy, appropriate surgical procedures are required.