Papilloma breast

  • Benign proliferation of duct epithelial and myoepithelial cells
  • 70% lesions central, involves main ducts in subareolar region
  • 30% occurs in peripheral breast, in terminal duct lobular units
  • Lesion is occult usually in mammography
  • Ultrasound and galactography are high yielding
  • Use generous gel, roll nipple to the side, and use an angled view to evade the sub- nipple shadowing
  • Ultrasound shows dilated ducts, with echogenic content, especially if there is discharge/bleeding
  • MRI T2 weighted sequences can show intraductal soft tissue appearing iso to hypointense in the background of a hyperintense duct
  • Contrast studies are often equivocal and excision is the standard treatment