Should I Be Worried About This Wart Near My Nipple?
If you find a wart-like lump near your nipple, don't get ahead of yourself and conclude it's cancer. Not all breast lumps are malignant. Many breast conditions, including intraductal papilloma, are benign.
While a single papilloma is most likely noncancerous, having multiple lumps is linked to a slight increase in breast cancer risk.
It's important to know more about intraductal papillomas, how to spot them and what course of action to take if you have a wart on your boob.
What is an intraductal papilloma?
Intraductal papillomas are harmless lumps that can form inside your breasts' milk ducts. These benign breast tumors are composed of different cells, including gland tissue, blood vessels and fibrous tissue.
They can grow either as single tumors or several growths in areas farther away from the nipple.
The exact cause of intraductal papillomas remains unknown. It is also unclear why cells in the ducts of the breasts grow faster than normal, with the overgrowth forming a small lump on your exterior boob.
Solitary papillomas are singular growths located inside milk ducts close to the nipple. As a result, they can often cause nipple discharge. This type of papilloma presents as a small and palpable mass next to or behind the nipple and can sometimes be painful.
Multiple papillomas, on the other hand, are tumors found in parts of the breast that are not close to the nipple. Unlike solitary papillomas, they don't usually cause a nipple discharge.
Who is at risk of developing a wart-like lump on their nipple?
Intraductal papillomas occur in cis women, most often between the ages of 35 and 55. While this condition can occur in men, it's rare.
"There are no universally agreed-upon risk factors for developing papillomas," explained Jane Kakkis, M.D., medical director of breast surgery at MemorialCare Breast Center at Orange Coast Medical Center.
"There are some studies to suggest it may be related to hormone levels," Kakkis continued. "The theory proposed is that either naturally produced hormones or taking hormone-based medications like oral contraceptives or hormone replacement may influence the development of papillomas."
How do you know it's a papilloma?
There are several physical signs you may have an intraductal papilloma. Symptoms include a painful or sensitive wart-like lump (or lumps) in the breast area and clear or bloody nipple discharge.
However, patients with small papillomas may not see nipple discharge or feel a lump in their breast. In this case, there are other methods of detecting intraductal papillomas, including ductograms (breast duct X-rays), imaging (such as mammogram, ultrasound and MRI) and biopsy.
What's the link between intraductal papillomas and breast cancer?
The American Cancer Society states that a singular intraductal papilloma is not associated with an increased risk of breast cancer.
"Having a single papilloma without any atypical features does not increase your risk for breast cancer," agreed Crystal Fancher, M.D., a surgical breast oncologist and assistant professor of surgery at the Saint John's Cancer Institute in Santa Monica, California.
"If [the papilloma] does have some atypia associated with it, that can increase your risk slightly," Fancher cautioned. "Some people who have multiple papillomas may also have a slightly increased risk for breast cancer."
These benign breast tumors are composed of different cells, including gland tissue, blood vessels and fibrous tissue.
Research verifies that multiple intraductal papillomas may put you at risk for cancer if accompanied by the following:
- Atypical ductal hyperplasia (ADH), which is a distorted pattern marking the overgrowth of cells lining the breast ducts or milk glands. A 2012 study published in the Annals of Surgical Oncology found that patients with ADH have an 18 percent chance of the condition becoming malignant.
- Ductal carcinoma in situ (DCIS), also called preinvasive breast cancer, which happens when cells lining the breast duct have turned cancerous but have not spread to surrounding tissue.
In addition, breast cancer risk is higher for women with a family history of cancer, or who have five or more intraductal papillomas developing at an early age.
What is the treatment and prevention for papilloma?
"In general, surgery is recommended to remove the papilloma. This is especially true if there is evidence of atypia on biopsy or symptoms such as bloody nipple discharge," Fancher said. "This is because we want to confirm there is not a cancerous or precancerous lesion in that same area."
However, surgery as an immediate treatment for non-atypical intraductal papillomas is controversial. In a 2018 study published in the Journal of Breast Cancer, researchers found that patients diagnosed with benign and solitary intraductal papillomas have zero to very low risk of developing cancer. Therefore, instead of excision, they recommend close observation.
"Although it is common to remove any papilloma surgically, small incidental papillomas that are not growing and do not look suspicious can be observed if there is no atypia on biopsy," Kakkis agreed. "Usually, one of the largest [papillomas] will be biopsied to verify the type of tissue in the mass, and then the papillomas will be observed for growth or other suspicious features. If anything of concern is seen then they are recommended to be surgically removed."
Unfortunately, there is no preventive measure for intraductal papillomas. Experts recommend early diagnosis and screening for women when they notice breast-related changes.
Therefore, always be breast aware and consult a health professional if you have any concerns. There is no better way to beat breast cancer than prompt treatment.