Imaging Diagnosis of Intraductal Papillomas of the Breast

Intraductal papilloma of the breast is a common benign mammary tumor and is one of the most common tumor associated with nipple discharge in woman. Patients with these lesions have an increased risk for the development of breast cancer. Our purpose was to determine the imaging features of intraductal papillomas of the breast and to assess their role in the evaluation of these patients. The clinical presentation and imaging findings, including mammography, ultrasonography, and ductography were retrospectively reviewed in 52 patients with histologically proven intraductal papillomas of the breast. Patients with these lesions commonly had nipple discharge (60%) and normal mammographic findings (52%). Ultrasonography identified abnormalities in 49 of 52 (94%) ultrasonograms. Dilated ducts with or without intraluminal echoes were noted in 17/49(35%) ultrasonograms, solid masses only in 13/49(27%), solid masses connected with dilated ducts in 11/49(22%), and cystic lesions with intracystic solid components in 8/49(16%). Findings were abnormal in all 24 ductograms, including both intraluminal filling defects and duct dilatation in 21 (88%) patients, total obstruction of the duct in 2(8%) patients, and only duct ectasia in 1(4%) patient. We conclude that ultrasonography is useful in the detection of intraductal lesions and contributes considerably to the diagnosis. Ductography can complement surgical excision by mapping the course of abnormal ducts and showing the location and full extent of intraductal papillomas.