Pathology - Intraductal papilloma

Pathology - Intraductal papilloma
A benign papillary tumor originating in the ductal system of the breast. Papillomas may arise throughout the ductal system, with a preference for either small terminal ductules (peripheral papillomas) or big lactiferous ducts (central papillomas).
Epidemiology • Prevalent. • Predominantly observed in women aged 40 to 59.
Aetiology • Considered to be neoplastic proliferations of glandular and stromal breast tissue.
Presentation • The majority of women with central papillomas have nipple discharge. • Minor peripheral papillomas typically manifest as a breast lump.
Macroscopy: Large papillomas appear as fragile lumps within an enlarged duct.
Cytopathology • Smears obtained from nipple discharge may exhibit branching papillaroid clusters of epithelial cells indicative of the diagnosis.

Histopathology • A papillary mass is observed with a ductal space. • The papillae are broad and rounded, allowing the fronds to interlock seamlessly. • Each frond is rich in stroma, consisting of blood vessels and fibrous tissue. • The epithelium enveloping the fronds is bilayered, comprising inner columnar epithelial cells and outer myoepithelial cells.

Prognosis: Benign lesions; nonetheless, several studies indicate that women with papillomas exhibit a twofold greater chance of developing future invasive breast cancer.