Duct papilloma

This is a relatively uncommon lesion

Clinical features:

• There is a serous or bloodstained discharge from a single aspect of the nipple, although the patient may not realise that the discharge is localised
• Other symptoms are rarely present
• The breast is normal, but there is either the spontaneous appearance of discharge from one aspect of the nipple or ‘milking’ of a segment produces nipple discharge from the duct draining that segment

Investigations:

• The main concern, particularly if the discharge is bloodstained, is that occasionally there is an underlying malignancy, although duct papilloma is benign
• Investigations are the same as for mammary duct ectasia
• In spite of negative cytological findings, it is nearly always necessary (in a bloodstained single duct discharge) to excise the involved system to establish that a papilloma is present