Multiple Papillomatosis of Breast and Patient's Choice of Treatment

Abstract

Papillary lesions of breast represent a range of lesions. Intraductal papilloma and its association with nipple discharge are well known. However, multiple papillomatosis has quite distinct characteristics and decision making can be somewhat challenging. We report a case of multiple papillomatosis in association with ductal carcinoma in situ (DCIS). Patient opted for ipsilateral mastectomy and prophylactic mastectomy of contralateral breast. Her decision of having prophylactic mastectomy was vindicated by presence of incidental DCIS in the contralateral breast. To our knowledge, this is the first reported case of multiple papillomatosis with DCIS of breast, along with incidental synchronous papillomatosis of contralateral breast with DCIS. The case illustrates few distinct features of multiple papillomatosis of breast and exemplifies how a patient's choice is so paramount in decision making process. Patients should be fully informed of the treatment options of the condition, and their wishes should be fully taken into account while making the final decision.

A retrospective observational study of intraductal breast papilloma and its coexisting lesions: A real‐world experience

“…A question that remains is how to determine solitary or multiple intraductal papillomas, whether by sonography, pathology, or both. Clinically, multiple papilloma is defined as the presence of at least five distinct independent papillomas in a segment of breast tissue, usually around or under the areola 2,41 . In ultrasound, solitary papilloma can be seen as an independent mass in the dilated mammary duct, a cystic or solid mass with a clear boundary 41,42 .…”

“…2,41 In ultrasound, solitary papilloma can be seen as an independent mass in the dilated mammary duct, a cystic or solid mass with a clear boundary. 41,42 Yi W et al confirmed single papilloma by ultrasound, 43 and Zhu Y et al defined it with a histopathologic diagnosis of solitary intraductal papilloma. 44 Clinically, there are discordant conclusions between sonography and pathology.…”

A retrospective observational study of intraductal breast papilloma and its coexisting lesions: A real-world experience.

“…Clinically, multiple papilloma is defined as the presence of at least five distinct independent papillomas in a segment of breast tissue, usually around or under the areola. [2,41] . In ultrasound, solitary papilloma can be seen as an independent mass in the dilated mammary duct, a cystic or solid mass with a clear boundary.…”

“…In ultrasound, solitary papilloma can be seen as an independent mass in the dilated mammary duct, a cystic or solid mass with a clear boundary. [41,42] . Yi W et al confirmed single papilloma by ultrasound, [43] and Zhu Y et al defined it with a histopathologic diagnosis of solitary intraductal papilloma [44] .…”

Intraductal papillomatosis of the breast in adolescents

“…İntraduktal papillomatozis, atipik duktal hiperplazi veya DKIS öncüsü olabilir. İntraduktal papillomatozisin DKIS'ya dönüşme oranı % 10-37,5 arasında değişmektedir (3) . Ciatto ve ark.…”