Resection of Ductal Papilloma of the Breast

Intraductal papillomas are benign epithelial lesions arising within the lactiferous ducts of the breast. They classically present with bloody or serous nipple discharge and are most often detected by imaging or galactography.

Surgical resection is recommended both for symptom relief and to exclude associated atypia or ductal carcinoma in situ. In solitary central papillomas, microdochectomy is the standard approach, removing the involved duct through a periareolar incision while preserving most of the central breast architecture. For multiple peripheral papillomas, more extensive duct excision or wider local resection may be required.

Preoperative localization with needle-guided wire, methylene blue or contrast galactography improves precision. Pathologic evaluation of the entire specimen is essential because foci of atypical hyperplasia or malignancy can change subsequent management, including the need for sentinel lymph node biopsy or completion surgery.