Intraductal Papilloma - Is a mastectomy necessary

What is the doctor's logic on removing it? You have what a lot of us were hoping to have..a benign papilloma!

A partial mastectomy is not the same thing as a mastectomy.  In fact in most cases when the term "partial mastectomy" is used, the surgery being done is exactly the same as a lumpectomy.  Technically with a partial mastectomy, more breast tissue is removed than with a lumpectomy but in reality most surgeons do partial mastectomies exactly the same way that they do lumpectomies.  Excisional biopsy is another term for exactly the same operation.  It's just a question of personal choice as to which term the surgeon uses.  The term "partial mastectomy" does however suggest that it's a much bigger surgery than it might actually be so I think your surgeon is not doing you any favors by calling it that.

Usually intraductal papillomas are removed, as redsox explained.  It may be possible to have the ductal excision - you definitely should ask about that.  And if not, you should ask that the smallest possible amount of breast tissue be removed during the lumpectomy.  Your intraductal papilloma is only about 1/8 of an inch in size.  While it should be removed, there is no reason why this needs to be disfiguring surgery.  If you aren't comfortable that your surgeon will try to minimize the impact on your breast, find another surgeon who will take this into consideration.

Good luck!

Intraductal papillomas are most often benign, but the standard of care is always removal and/or excision, especially when found on needle biopsy. Reason being, with approx. 25 % of all cases, early staged cancers can be found nearby. I believe you have been highly mis-informed when a resident AND/OR intern says this will never turn into cancer. He/she needs to take a closer look at the research studies or pay close attention to what an attending surgical oncologist would recommend!!! Partial mastectomy or Lumpectomy terms are often used inter-changeably, both indicating the same procedure, but conservation should be a definite consideration for purposes of this excision. Keep us posted, we care.

Papillomas are related to cancer in a very, very low percentage of the time (but a percentage means nothing if the number comes up as you).  As I understand it, though, the best look at it is with a surgical biopsy to remove the piece and see it in the lab.  Your area seems fairly small, but I understand your concerns of disfigurement.  A good breast surgeon can guide you best as to how it would go for you.  Get a second opinion, too, since someone may have a different technique that you'd prefer. One thing is for sure, this is not an emergency.  You do need to look into it, but you have time to interview 2 or 3 doctors, or to read up on things more, if any of that adds some security for you.

I have a very long struggle with papillomas.  Yes the reason they are removed is cancer or ADH can often be around or hiding behind them.  Another reason for removal is once the surgeon gets into the area, they may find more than one papilloma.  The usual course would be either removal of the papilloma or the whole ductal system.  Trust me I have had every kind of removal you can do for these pesty things and sometimes they have friends nearby either ADH or other benign lumps.  After several surgeries in a short time, my surgeon also did a partial mastectomy.  That term was used for two reasons.  First, he did a pie slice, removing one third of the breast, he considered more than 1/4 removal of the pie a partial mastectomy (assuming this was his own definition).  The second is the use of the term for insurance purposes.  In the state of Oregon if a woman has had a mastectomy of any kind, insurance has to allow reconstruction, a lumpectomy is a much harder hoop to jump through for reconstruction insurance coverage.  In reading the boards, I find insurance around are my area seems tougher than say the east coast, getting an MRI without a family history can be a nightmare. 

Now, the original posters case (Lindamariel) seems very odd to me, that is a very small papilloma to do a large removal unless they would suspect more papillomas in the system.  I have had small papillomas if they are closer to the surface, removed in the procedure room of the surgeons office.  Larger and deeper as a lumpectomy removal, more than one I usually have had a ductal excision.  Like I said before the partial mastectomy took place when I was having surgeries every three months.  I would get a second opinion for sure.  Seems way too extreme.