Article Sections

Introduction

Intraductal papillomas ( Figure 1) are benign papillary tumors arising from the lining of breast ducts.  They are the most common cause of unilateral, bloody nipple discharge.

Pathophysiology

Intraductal papillomas are benign lesions that arise from the lining of the breast ducts.  They are papillary projections composed of epithelial and myoepithelial cells that line a fibrovascular stalk ( Image 1).  Twisting of the stalk causes intraluminal bleeding with subsequent bloody nipple discharge.

Intraductal papillomas are usually small (≤1 cm) and may be solitary or multiple.  They most often occur near the areola within the central breast.  Because of their size and location, they are often not palpable clinically.  On occasion, there may be cellular atypia (ie, atypical hyperplasia) or even ductal carcinoma in situ (DCIS) within the papilloma.

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