ABSTRACT
Papillomas arise within a duct, either central or peripheral. They are usually small lesions but on rare occasions can present as a large lump. Histologically, they are composed of papillary projections with an arborescent, fibrovascular stromal core. Myoepithelial cell immunohistochemistry may also be helpful in difficult cases. Single-duct spontaneous nipple discharge, either clear or blood stained, is the commonest presentation, especially for solitary/central papilloma. Papillomas situated in the peripheral breast parenchyma are often asymptomatic, although they may result in a lump if large. Peripheral papillomas are more commonly part of MP as opposed to central duct papillomas, although this is not an absolute rule. In 2018, a multidisciplinary working group issued guidelines for the diagnosis and management of B3 lesions on core biopsy. Epithelial atypia seen at definitive histology usually represents increased future cancer risk thereby leading to a recommendation of additional annual surveillance.
