Intraductal Papillomas of the Breast

Intraductal papillomas are benign (non-cancerous), wart-like tumors that grow within the milk ducts of the breast. They are made up of gland tissue along with fibrous tissue and blood vessels (called fibrovascular tissue).

What are intraductal papillomas?

Solitary papillomas (solitary intraductal papillomas) are single tumors that often grow in the large milk ducts near the nipple. They are a common cause of clear or bloody nipple discharge, especially when it comes from only one breast. They may be felt as a small lump behind or next to the nipple. Sometimes they can be painful.

Papillomas may also be found in small ducts in areas of the breast farther from the nipple. In this case, there are often several growths (multiple papillomas). These are less likely to cause nipple discharge.

In papillomatosis, there are very small areas of cell growth within the ducts, but they aren’t as distinct as papillomas are. 

Diagnosis of breast papillomas

Papillomas might cause symptoms such as clear or bloody nipple discharge (or a breast lump), or they might show up as an abnormal area on an imaging test (such as a mammogram or breast ultrasound).

A ductogram (galactogram), in which dye is injected into the nipple duct where the discharge is likely coming from and then an x-ray is taken, may sometimes be helpful in finding papillomas.

If symptoms or an imaging test can pinpoint an area of concern, a breast biopsy of the area can be done to confirm the diagnosis. In some cases, surgery (duct excision) may be done to look at the area more closely.

How do intraductal papillomas affect your risk for breast cancer?

Having a single (solitary) papilloma does not raise breast cancer risk unless it contains other breast changes, such as atypical hyperplasia. However, having multiple papillomas increases breast cancer risk slightly.

Treatment of breast papillomas

Whether or not papillomas need to be treated depends on factors such as their size, if there is more than one, and if they’re causing symptoms. Because papillomas can sometimes be linked with other, more serious breast findings, doctors may recommend surgery to remove them and the part of the duct they're in.