Date: January 31st, 2011
Status: Yet Another New Medical Term
Info: You may remember a blog about a difficult day in recent postings concerning a receptionist at Sutter Women’s Health. She called Bonnie one afternoon to inform her additional findings were found on her right breast – all of this information came from an unknown source (at the time) as Bonnie was expecting a call from her surgeon. Well – before we can proceed with the surgeon and her tools of the trade we need to ensure the findings on her right breast are nothing to worry about. That is where this story finds us.
New Medical Term: Inraductal Papilloma
An intraductal papilloma is a tiny wart-like growth in breast tissue that sometimes punctures a duct. These benign tumors are composed of fibrous tissue and blood vessels. Intraductal papillomas grow inside your breast’s milk ducts, and can cause benign nipple discharge.
What do Intraductal Papillomas Feel Like?:
If you have just one intraductal papilloma, and it is near or just beside a nipple, it may feel like a small lump. Solitary intraductal papillomas usually occur in the large milk ducts near your nipple. When one of these breaks a duct, it can cause a little clear or bloody nipple discharge, which is usually not worrisome. If you have multiple papillomas, they usually occur deeper inside your breast, and can’t easily be felt. A group of papillomas like this won’t cause nipple discharge. Today Dr. McDonald biopsied two of these. This biopsy was extremely painful due to its location near the nipple.
Getting a Clear Diagnosis:
If you find a small lump quite near your nipple and see some discharge, keep an eye on it. If it doesn’t grow, and the discharge ceases, chances are it is benign. See your doctor or nurse practitioner for a clinical breast exam, or if you want to have the fluid tested. If the lump is large enough for you to easily feel it, you may want to have a needle biopsy done, and the tissue sample examined. You may also consider having the lump imaged, a technique called a ductogram.
I don’t remember the term “ductogram” yesterday and that may be directly related to the amount of alcohol we both consumed after this afternoon’s biopsy. I have the receipt to prove it.
What is a Ductogram (Galactogram)?:
A ductogram, or galactogram, is an imaging study done specifically on the milk duct system. To begin this procedure, a patient must squeeze a small bit of discharge from the nipple, so that the radiologist can see exactly which duct is leaking. Once the duct is found, the radiologist gently inserts a very fine hollow needle into the duct, and injects some contrast fluid into the duct network. This contrast fluid will show up on a mammogram, and trace the related ducts. The resulting image may help to reveal the cause of your nipple discharge.
When the biopsy was finished yesterday we celebrated in the fact there was to be no post-mammogram. Yes, we take joy in missing the easy procedures.
Types of Intraductal Papillomas:
There are two types, and one related condition:
Solitary intraductal papillomas – one lump, usually near a nipple, causes nipple discharge
Multiple papillomas – groups of lumps, farther away from a nipple, usually doesn’t cause discharge, and can’t be felt
Papillomatosis – very small groups of cells inside the ducts, a type of hyperplasia, more scattered than multiple papillomas
How are Intraductal Papillomas Treated?:
Intraductal papillomas can be surgically removed if they prove bothersome. A small incision is made along the edge of your areola, then the papilloma and its duct are removed. The resulting scar can be nearly undetectable.
Do Intraductal Papillomas Increase Your Risk for Breast Cancer?:
Having solitary intraductal papillomas does not increase your risk for breast cancer, unless they are composed of other conditions, such as atypical hyperplasia. If you have multiple papillomas or papillomatosis, your risk for developing breast cancer is slightly increased.
Bonnie was very tense after we left. She’s been extremely tight around the neck and shoulder areas and normally I can lay my paws in there and take care of business with a neck and shoulder massage, however this time I’m calling in the professionals – and placed a call to Michelle who is going to work her professional magic tomorrow afternoon. Doubt TRICARE is going to accept a claim for a neck/shoulder massage, but it may be worth investigating.
We received some very positive feedback from Bonnie’s Boosters today and you all know who you are. The bartender yesterday is saying to herself: “This is how they handle breast cancer? Okay – laughter really is the best medicine.”
Thanks for keeping her close you guys.