Annals of Surgical Oncology

, Volume 16, Issue 8, pp 2264–2269 | Cite as

Management of Intraductal Papillomas of the Breast: An Analysis of 129 Cases and Their Outcome

  • Nasim Ahmadiyeh
  • Mariana A. Stoleru
  • Sughra Raza
  • Susan C. Lester
  • Mehra Golshan
Breast Oncology



The management of intraductal papillomas of the breast has been controversial; some advocate surgical excision of all lesions despite benign pathologic features, whereas others excise only those specimens with atypia.


We conducted a retrospective review of 129 core-biopsy-proven papillomas of the breast with atypia (n = 43) and without atypia (n = 86) and determined the rate of missed carcinoma in surgically excised specimen in each group.


Carcinoma was found in 22.5% of the surgically excised specimens in the atypia group (9/40) and in 3% of the surgically excised specimens in the no atypia group (1/29).


Our findings confirm the practice that papillomas with atypical features should be excised, and suggest that in patients with adequate follow-up, benign papillomas may be managed conservatively.


  1. 1.
    Agoff SN, Lawton TJ. Papillary lesions of the breast with and without atypical ductal hyperplasia. Can we accurately predict benign behavior from core needle biopsy? Am J Clin Pathol. 2004;122:440–3.PubMedCrossRefGoogle Scholar
  2. 2.
    Sydnor MK, Wilson JD, Hijaz TA, Massey HD, Shaw de Paredes ES. Underestimation of the presence of breast carcinoma in papillary lesions initially diagnosed at core-needle biopsy. Radiology. 2007;242:58–62.PubMedCrossRefGoogle Scholar
  3. 3.
    Renshaw AA, Derhagopian RP, Tizol-Blanco DM, Gould EW. Papillomas and atypical papillomas in breast core needle biopsy specimens. Risk of carcinoma in subsequent excision. Am J Clin Pathol. 2004;122:217–21.PubMedCrossRefGoogle Scholar
  4. 4.
    Sohn V, Keylock J, Arthurs Z, Wilson A, Herbert G, Perry J, et al. Breast papillomas in the era of percutaneous needle biopsy. Ann Surg Oncol. 2007;14:2979–84.PubMedCrossRefGoogle Scholar
  5. 5.
    Collins LC, Schnitt SJ. Papillary lesions of the breast: selected diagnostic and management issues. Histopathology. 2008;52:20–9.PubMedGoogle Scholar
  6. 6.
    Jacobs TW, Connolly JL, Schnitt SJ. Nonmalignant lesions in breast core needle biopsies: to excise or not to excise? Am J Surg Pathol. 2002;26:1095–110.PubMedCrossRefGoogle Scholar
  7. 7.
    Rizzo M, Lund MJ, Oprea G, Schniederjan M, Wood WC, Mosunjac M. Surgical follow-up and clinical presentation of 142 breast papillary lesions diagnosed by ultrasound-guided core-needle biopsy. Ann Surg Oncol. 2008;15:1040–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Page DL, Salhany KE, Jensen RA, Dupont WD. Subsequent breast carcinoma risk after biopsy with atypia in a breast papilloma. Cancer. 1996;78:258–66.PubMedCrossRefGoogle Scholar
  9. 9.
    Lewis JT, Hartmann LC, Vierkant RA, et al. An analysis of breast cancer risk in women with single, multiple, and atypical papilloma. Am J Surg Pathol. 2006;30:665–72.PubMedCrossRefGoogle Scholar
  10. 10.
    Tavassoli FA. Pathology of the breast, 2nd ed. Stamford, CT: Appleton and Lange; 1999.Google Scholar
  11. 11.
    Marshall LM, Hunter DJ, Connolly JL, Schnitt SJ, Byrne C, London SJ, et al. Risk of breast cancer associated with atypical hyperplasia of lobular and ductal types. Cancer Epidemiol Biomarkers Prev. 1997;6:297–301.PubMedGoogle Scholar
  12. 12.
    Sakr R, Rouzier R, Salem C, Antoine M, Chopier J, Arai E, et al. Risk of breast cancer associated with papilloma. Eur J Surg Oncol. 2008;34:1304–8.PubMedGoogle Scholar

Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Nasim Ahmadiyeh
    • 1
  • Mariana A. Stoleru
    • 2
  • Sughra Raza
    • 3
  • Susan C. Lester
    • 2
  • Mehra Golshan
    • 1
  1. 1.Department of SurgeryBrigham and Women’s Hospital and the Dana Farber Cancer InstituteBostonUSA
  2. 2.Department of PathologyBrigham and Women’s HospitalBostonUSA
  3. 3.Department of RadiologyBrigham and Women’s HospitalBostonUSA

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