Are solitary breast papillomas entirely benign?
OBJECTIVE
Solitary breast papillomas are potentially malignant and are associated with a higher risk of breast cancer.


METHODS
Retrospective review of all pathological reports containing breast papilloma (1983-2000) and review of selected specimens.


METHODS
Tertiary, referral, university-affiliated medical center.


METHODS
Ninety-five women with a breast specimen containing a papilloma or papillomatosis. Patients with overt papillary carcinoma without papilloma were excluded.


METHODS
All histopathological characteristics of the papilloma and the surrounding tissue were noted. The incidence of malignant and other proliferative histopathological findings were analyzed, comparing solitary ductal papilloma cases to multiple papilloma cases. The Fisher exact test and chi2 test were applied for statistical analysis.


METHODS
Surgical removal of solitary ductal papillomas should include margins wide enough to secure removal of any proliferative tissue within or around the papilloma and to enable thorough evaluation of the risk for future breast cancer.


RESULTS
Solitary papillomas were associated with breast carcinoma in 7 patients (10%) in this series. An additional 9% (n = 6) presented with invasive or noninvasive carcinoma within the papilloma. Atypical papilloma was noted in 6% of patients (n = 4). The risk of associated malignancy was not significantly different between solitary ductal papilloma and multiple papilloma.


CONCLUSIONS
Increased risk of breast cancer is associated with all forms of papilloma.
Gutman
Haim
H
Department of Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel. hgutman@post.tau.ac.il
Schachter
Jacob
J
Wasserberg
Nir
N
Shechtman
Itzchak
I
Greiff
Franklin
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D010212:Papilloma / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies