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Intraductal Papillomas
General questions about intraductal papillomas.
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AskedPublicly Submitted Question
10/13/2017after a self-examination I found a lump. I barely have any breast, I am quite flat chested (donít even need a bra, because my breast are just tiny) and was surprised to even have a lump (especially because I was only 30 with no incidence of breast diseases in my family).

At first I left it alone for a month wishing itíd disappear but I grew more concerned and decided to see a doctor. He said that the fact it was mobile was good and sent me to get a mammography. I also went to my gynaecologist who suggested also a mammography plus an echograph.

At the radiologist he did first a mammo and then echograph and because he couldnít tell for sure he suggested a biopsy right there. He did a core biopsy with around 6 samples and mentioned having micro calcifications.
A month later the results came is as papilloma and adenosis benign. I went back to see the gynaecologist and he suggested waiting 6 months and redoing the mammography. But if this was stressing me mentally it could be surgically removed. The lump was 20 mm X 12 mm X 7 mm.

I went to get a second opinion to calm myself. I showed this another gynaecologist (the x-rays, echographs and the pathology report) and she got stuck on the papilloma. She did a few echographs as well and decided it was best to get yet another opinion from the hospital. I went to get this third opinion at the hospital, where I saw a radiologist, she again examined all the previous documents and said she suggests excision. But first she would ask the lab for the biopsy samples so they could reanalyse it and confirm the results. Eventually they confirmed the results saying that is a B3 lesion and that they recommend excision.

By this time, I was very nervous and crying multiple times a day. I met up with two surgeons about my lump and they say they recommend the extraction because although the reports are benign, they cannot completely rule out cancer. The surgical procedure they performed was an open removal of tissue which was wire guided.

Itís been two weeks since the operation. Generally I didnít have much pain, just a lot of nausea which has now stopped. When I first touched my breast after the operation (3 days after) I felt a tender lump which freaked me out. I had a post-op surgery discussion with the surgeon and asked about it and he said that is probably an hematoma, following that he said that they did not take all the lump out as the goal was to make sure there was no cancer. This completely threw me off. He said that pathology confirmed that, there was no cancer which should be good news, but I was stuck thinking at why they didnít take the entire lump.

When I asked why he said that it maybe was not explained to me correctly, and that the objective of this surgery was to see if cancer was present. And itís not.

Now I tried searching online about this and couldnít find any answers. I just do not understand why the entire lump was not taken out. I was wondering if you would please help me with my questions:

1. why wouldnít the entire lump be removed?
2. isnít there a risk that the part that they didnít take out contain cancer?
3. Because part of the papilloma was left inside couldnít it just grow back?
4. Is this new tender lump a cause of worry? (I read on your website that it could be serum, hematoma and that they usually resolve on their own. Mine seems to be a bit bigger than the lump I had, and it worries me to death that I could have this forever from now own). How likely is it that it will stay like this forever? is there anything I could be doing to help it heal? Massage? hot compress?
RepliedJHU's Breast Center Reply
10/13/2017The procedure should be to remove the entire papilloma and some tissue around it. no idea what was left behind. perhaps an ultrasound could determine this. it is common to have a lump remain for months due to hematoma and scar tissue forming. the pathologist can determine if all of the papilloma was removed.

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