Treatment for intraductal pappiloma

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Nagould0409
Nagould0409 Member Posts: 1
edited January 2018 in Benign Breast Conditions

I had my consult today following core needle biopsy. Diagnosis was intraductal pappiloma which was benign. Everything I read on it says removal is typical treatment but the surgeon today did not recommend it saying it was unnecessary. Anyone else have a similar recommendation against surgery? This is all new to me

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  • Moderators
    Moderators Member Posts: 25,912
    edited November 2017

    Hi Nagould, and welcome to Breastcancer.org! Sorry we can't really help you with your question but hope you get responses from other members soon! In the mean time, you may want to take a look at the article Certain Breast Changes from our main site, with some general steps you can take if you've been diagnosed with a benign breast condition.

    Hope this helps!

    The Mods


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  • Mel1969
    Mel1969 Member Posts: 116
    edited December 2017

    No, from what I researched online the recommendation is to surgically excise all papillary lesions due to small chance of dcis hidden below or within the margins.

    I had mine surgically excised and it had atypical cells that were found on pathology.

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  • Silbar
    Silbar Member Posts: 163
    edited December 2017

    My recent mammogram & ultrasound showed microcalcifications. I just had a stereotactic biopsy and it showed  a papilloma with microcalcifications but no atypia. The breast surgeon recommended an excisional biopsy to completely rule out any underlying conditions.

    Mel1969: did you know you had atypical cells before the surgical excision? Did you have a core needle or stereotactic biopsy first? What were your findings before the excision? 

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  • Roller40
    Roller40 Member Posts: 30
    edited December 2017

    I just had a lumpectomy for what they think is a papilloma. We didn't biopsy it instead we just went right to lumpectomy. My BS said she always removes papillomas. Waiting on pathology and really hoping that is all I have going on

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  • Silbar
    Silbar Member Posts: 163
    edited December 2017

    Roller40: My papilloma did not show up on mammogram or US, only on biopsy. What made your dr suspect it in your case

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  • Silbar
    Silbar Member Posts: 163
    edited December 2017

    @nagould: Did your dr explain to why he believes removal is not necessary?

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  • Mel1969
    Mel1969 Member Posts: 116
    edited December 2017

    SILBAR, mammogram showed a mass and then they did an ultrasound. A month later they did a core needle biopsy which just showed papillary lesion. They didn't find the ADH until the first excisional biopsy. Unfortunately, margins contained ADH so I was re-excise 2 weeks ago.

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  • Silbar
    Silbar Member Posts: 163
    edited December 2017

    Mel, thank you for explaining. That is my biggest concern right now...that the stereotactic biopsy showed peripheral ductal papilloma with cluster of micro calcifications. I am still worried about what else might be lurking in there as the BS has recommended an excisional biopsy to be sure. I am still in the waiting game...think I will post a separate thread so I don't hijack this one

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  • Silbar
    Silbar Member Posts: 163
    edited January 2018

    Mel~~have you gotten the results from your re-excision yet? I hope you have clean margins now and no further treatments needed.

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  • Silbar
    Silbar Member Posts: 163
    edited January 2018

    I wonder how many people here go in for a core needle or stereotactic biopsy and it shows papilloma and micro calcifications and then the excisional biopsy discovers other issues such as DCIS or ADH?

    I know this happened to Mel...any others here? The waiting to get my excisional biopsy is killing me. I am almost at the point of bypassing the insurance and just pay out of pocket. I have no idea what that would cost.

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  • Roller40
    Roller40 Member Posts: 30
    edited January 2018

    silbar.... I had nipple discharge went to BS couldn't feel anything. Sent for mammogram and ultrasound and they seen a 8mm mass within a dilated duct with calcification

    Radiologist thought calcifications were benign requested excision biopsy of papilloma


    So now I wait for results and hoping that is all it is.

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  • triscuit
    triscuit Member Posts: 31
    edited January 2018

    I have had 4 core needle biopsies in my left breast. For all 4, the pathology report indicated intraductal papilloma. My breast surgeon doesn't want to excise them because there are "too many" and she feels like the cosmetic result would be bad, which she doesn't want to do for a completely benign condition. I am uncomfortable with the risk of multiple peripheral papillomas, with microcalcifications evident on imaging also. I am currently on an every 6 month ultrasound and MRI protocol but I am also planning to seek a second opinion. It seems so odd to me that if it was just one papilloma it would almost certainly be excised, now I have several (probably more because my breasts are very "busy") and we just leave them?

    Silbar - that's the question I have too. How often is there something else behind it?


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  • Mel1969
    Mel1969 Member Posts: 116
    edited January 2018

    SILBAR, yes the re-excision got the remaining adh and clean margins.

    The re-excision was more difficult due to he had to resect through scar tissue and the surgery itself took longer than expected. The recovery was quite different from the first excision. I had more pain that required medication, more swelling and I required a Penrose drain and staples. The first excision was a breeze compared to the re-excision.

    I highly recommend buying a snug sports bra that zips or clasps in front with out underwire. I bought round ice packs on Amazon that fit perfectly in the bra, used them both times.

    I wouldnt pay out of pocket, just wait. Those micro calcification have been there awhile, a few weeks Will not make a difference. I know it's nerve wracking but try to be patient.

    Good luck and best wishes ladies on your upcoming surgeries.

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  • Silbar
    Silbar Member Posts: 163
    edited January 2018

    Mel~~ I'm glad that your margins came back clean this time! Regarding the bra...I had a lot of discomfort due to the large hematoma after my stereo bx. I tried to wear my bra at night but they are all underwire. I ended up wearing a tight camisole with wireless support. My BS said that he might be able to make the incision along the bottom of my breat rather than from around the areola. I did order a few wireless bras that have hooks in the front. I'm still looking for a decent sports bra that hooks in front that fits my 34DDD.

    The only reason I was willing to pay for the BS visit out of pocket is because the insurance said that it can take 30 days for authorization for me to even go back and see him. Then it can take another 30 days to authorize the excision...that is 2 months of waiting. Anyway, I know that I can't make the process go any faster by stressing over it so I will take it as it comes. I will look up on Amazon for those circular ice patches. Thanks.

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