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Intraductal Papilloma of the Breast - Nipple Exploration / Duct Excision
Greetings and salutations. I'm 32 years old and experiencing my first breast cancer scare, though it is very likely I'm dealing with a completely benign breast disease.
I've been experiencing bloody nipple discharge, which seemed to disappear on its own for a couple of months but returned around Thanksgiving. The smear, mammogram and ultrasound were all clear, but my surgeon is recommending a nipple exploration and duct excision to identify the cause (likely a benign papilloma), excise the offending duct and perform a biopsy to rule out cancer. On the whole, I'm cool with this. If I have cancer, I want to deal with it head on. If it's just a benign papilloma, I'd rather have it removed and the bleeding stopped.
But, I am very, very nervous (however superficial it sounds) about damaging my nipple. I'm a wee vain about my breasts but can handle a little scar. What concerns me is permanent loss of sensation or the nipple no longer becoming erect post-surgery. There's some concern about the nipple inverting, but I think that's more likely after a total duct excision, and in my case the assumption is that a single duct and a little bit of the surrounding area will be excised.
The surgeon is lovely and sympathetic, but he was very noncommittal about post-surgery side effects. He said that circumareolar is usually the cosmetic preference (because the scar is more easily hidden), but offers a greater chance for nerve damage. He then suggested a radial incision (which leaves a more visible mark, but distresses the nipple less) based on my primary concerns.
If anyone here has had a similar experience/procedure, I'd really love to hear your story, your incision preference. Post-surgery recovery time, etc.
And my sincere apologies if this really does seem a vain and superficial concern. I know many here have been put through worse and have lost more.
GirlDetective,
I am 39. I am 9 months from having a duct removed due to bloody discharge from the nipple. It was quite shocking when I found it. I had initially gone in and had a mammogram because of a lump I found on the left side. Nothing showed up on the mammo. I went in for an ultrasound to concentrate on the lump on the left side. It turned out to be a cyst. Between the time of the mammo and the ultrasound, I kept feeling like my breast was leaking but could never confirm it until I gave it a little squeeze. That's when I found the bloody discharge. I went back to my GYN. He did a smear which showed no cancer cells and sent me to a Breast Surgeon. She tested the discharge to see if it was in fact blood and decided at that point it needed to come out. I went in for outpatient surgery in March. I'm not exactly sure which incision the surgeon used. All I can tell you is what I saw. When I woke up, I experienced burning on the nipple. I was given vicadin for pain management. There was a square guaze pad over my nipple with a big clear adhesive patch over it. I was allowed to change the bandages the next day. The surgeon used butterfly tape on the outside along the the incision. All other stitches were inside and dissolvable. My nipple was cut from the center lead outward about 4 inches toward my armpit. Apparently, they inserted a small wire into the duct that was affect then followed it to the chest wall so the entire duct would be taken out. My surgeon has had 20 year experience. She said she doesn't put stitches in the nipple and areola area. Apparently, the area doesn't heal up as nicely. I highly recommend that you get a couple of gym bras so that you can be really tight. It's very uncomfortable up to two weeks after the surgery. You just don't want to move around. Also, if the surgery is going to be the same as mine, stock up on something like neosporin. I had to keep that one my nipple while it was healing along with nonstick guaze pads. There is no scaring on the skin part of my breast. My nipple looks pretty good but be warned it will look pretty bad at first. That was really hard for me to swallow and I didn't think I had body/vainty issues. It will heal up very nicely. My nipple is not inverted. It doesn't stick up as much as the other one but only I notice. I have started to leak a thick white discharge lately so I've got back in to the GYN. When he did a breast exam, he needed to ask me where the incision was. He couldn't find it. Ok....numbness. There was some. It was really irrating to wear a bra for awhile after the incision was healed and I was no longer wearing guaze pads. The numbness has gone away for the most part but right now I'm just having the issue with one another duct that's right on the incision line. The scar right on the areola and nipple is very soar like it has some sort of cyst under it. The 17th is my next appointment with the surgeon. Hope that answers all your questions. Feel free to email me if you have any questions. When I was going through this I couldn't find anyone else who has had this. By the way, mine was benign.
c3virginia
Hi,this is my first time at posting a message,please bear with me,i have a clear watery discharge from my right breast,it seems to be coming from one duct,only when squeezed though,i went to see my doctor last week,he said i have no lumps.
I asked him if it could be a papilloma & he said no,could anyone please help,i have an appointment next weeek at a breast clinic but it seems such a long lonely wait,i would be very grateful if anyone has any ideas.
Thanks xx
Hi,
I have had a pus discharge from one nipple - one duct I think since the end of August. I previously had a benign lump removed from the same breast in August 2007.
I had a clear mammogram on the 7th of September and the doctor at the clinic (Northampton) told my GP that he didn't want to do anything else as the duct excision is quite a big operation leading to possible loss of sensitivity / scars etc.
I wasn't happy with his suggestion of 'come back in a year if it's still there' as I currently have to wear a breast feeding pad in my bra day and night - sexy!
Anyway, last week it turned bloody for a week - although it is back to pus now. I have asked my GP for a second opinion and am going to Coventry clinic this Saturday - I'll let you know what they say as it might offer you some help?
Jane
xxx
Hi Jane,& thank you,im so worried,im new to all this,apart from painfull breasts around the time of periods,i have never had any problems.I hope everthing goes well on Saturday for you,please let me know how you get on,i have my appointment on Monday morning,i will be glad to know what is going off,i have spoken to a lady on the helpline & she said it sounds like a intraductal papilloma,last night i found a very small lump 4mm ish behind the nipple,when i squeezed it the discharge came out,so i think iv found the trouble area
thanks again, xxx
I had an indtraductal papilloma two years ago. I noticed staining on my bra and immediately panicked. However, I was reassured that it was benign and it was removed during day surgery. I had been told that there was a possibility of recurrance so when I noticed staining on my bra (same breast) again this year, I didn't worry too much. Trouble is, this time it was cancer. Have subsequently had a mastectomy with TRAM reconstruction and am about to start chemo (3 FEC, 3 Tax).
I've been told that there's no link between an Intraductal Papilloma and Cancer - but it does seem to be a strange coincidence.... Anyone else had anything similar?
Just got back from Coventry - very impressive service!
Saw the surgeon first and he agreed that I should have a duct excision to sort out the discharge and check it out too - although he was pretty positive. He said it would probably be soon after Christmas.
I then had a mammogram just of the right breast which was fine. I then went for an ultrasound. The consultant radiologist was very nice and said firstly that it could take a while because ducts can be tricky to see but then immediately she found an enlarged duct - she said it could be an infection. From another angle she found what she called 'debris' so before I could register fully what was going on I was having 2 core biopsies.
She gave a local anaesthetic and then took two samples from behind the nipple - it is pretty unpleasant, I won't lie to you. I am sitting typing with a packet of frozen peas sitting on my bruised boob.
She said it was most likely a papilloma but there was a chance of cancer so I have another appointment at 9.30 next Saturday.
Hope your appointment goes well on Monday and you are treated as well as I was at Coventry.
Jane
xxx
Sorry - double post
Hi Jane,thanks for letting me know how you got on,been thinking about you all day,hope you're sitting without the peas and feeling more comfortable now,it sounds very unpleasant,do you get your results next Saturday?im sorry to sound naive,i have no idea how long it takes,i think the waiting is dreadful.
Hi Maxpax i am sorry to hear all what you have had to go through,everone is so brave on here,i feel im over reacting by panicing,and i dont know if there is anything wrong yet.
xxx
Evening,
Yes - I will get the results next Saturday. I don't know where you are going on Monday but my experience suggests that you do need to have an ultrasound as well as a mammogram so bear that in mind as nothing showed on my mammogram but my ducts showed as enlarged etc on the ultrasound.
I hope it goes OK for you. Don't apologise for your reaction - we all feel differently at different times.
Jane
xxx
Hi Chestnut - how did it go his morning?
Jane
x
Hi Jane,the service i recieved was fantastic like yours,thankfuly everything is ok,i had a mammogram & was told to wait a while to be called for my ultrasound,but then i got asked to go for another mammogram as there was something like a lump showing on my other breast in the nipple ,as you can imagine,i really thought that something was very wrong at this point,i then went through for the ultrasound which showed nothing,the doctor said it was just an irregularity & that it was nothing to worry about & that a lot of women have discharge for no reason,i was very glad to leave quickly with that answer,i must say the whole morning went in a blur,i do hope that everything is ok for you too on Saturday,please let me know.
xxx
Hi Chestnut
I don't want to scare you and won't go into many details here (if you read back on some of my posts you might understand why), however, if this discharge turns bloody or does not clear up soon, please, please do not leave it.
Hope the discharge stops soon with no further worries for you.
xx
Chestnut,
Great news - but I agree, do go back if it doesn't stop. I have had my discharge since the end of August and was only given a mammogram by the first doctor - it took a different hospital to give me the ultrasound that showed the potential problem.
Jane
x
Hi Jane,hope you're ok,i have had an ultrasound today,doctor said it was clear,i have no idea what shapes she was looking for?
xxx
Hi peacock,i have written a message earlier but it doesnt seem to have posted?,as im new to this i dont know how to look through your past messages,i understand what you're saying,i think,if i see any change i will go back to my doctor.Before i went to the clinic today i rang a private clinic for some advise & was told any discharge from one duct in one nipple is abnormal,yet today i was told it was common for womens breast to leak,the doctor said if you squeeze 10 womens breasts,7 will leak?
xxx
Chestnut,
I think amount of discharge is important - the Dr asked me if it was an occasional drip or all day, every day (it is the later - although it has stopped since the core biopsies - I expect the duct is blocked because it is swollen). That could be the difference - also my discharge has recently become bloody. My discharge happens without squeezing also - literally runs down my boob when undressed.
It's obviously great news for you - especially as you had the ultrasound show clear too. I think you're wise though to consider a second opinion if it doesn't clear up after a while.
Jane
x
Hi Jane,thank you for all your help and support over the last week or so,it was a great help to talk to someone going through similar problems,im not sure i would have coped as well without this site,please let me know how you get on at weekend,i will be thinking of you,here if you need to chat,anytime!
xxx
If you're still there Chestnut - I have a papilloma which will be surgically removed just after Christmas - to give me time to recover from the surgery I need on Tuesday - pity they can't do it all while I'm under!
Jane
x
Hi Jane,yes it is a shame they cant do it while you are under,hope all goes well for you on Tuesday,& hope you're coping ok,have been thinking of you,i have been told to go back to my doctors if my discharge continues,its still there,so im not sure how long i have to wait for it to stop?
xxx
Hi
Just to let you know that I had an introductal papilloma about 3.5 years ago. I had this sticky clear to yellow discharge from my right nipple for a while and i did a mammo and an ultra sound. They also did a biopsy but my doctor(who was a breast specialist) advised it be excised to rule out any malignancy. The operation was very simple and i didnt even have to stay in the hospital for the night. They had done an incision on the aleaora area(it is very pale now, I have problem seeing the mark!). I had no complications and i dont have any side effects like numbness of nipple or anything. The only problem is that it still gets a bit sore if i exercise ( i play volleyball) for a long time, but it is not unbearable. Anyway, it seems to be the best solution and it really is not a complicated procedure, but at least you have peace of mind since they can give you a definite answer that it is not malignant after excision. My doctor also mentioned that these types of lesions DO NOT increase the chances of getting breast cancer. HOpe this helps
Hi, this is the first time I've posted on here. I had a microdochectomy on 9th December as a day case under a GA.
Had been having a blood stained discharge from one duct for past few weeks. Had a mammogram which was ok and an ultrasound which showed a couple of dilated ducts. The breast surgeon said they had to remove and examine the duct to rule out any problems as any lesion in the duct wouldn't show up on a mammogram.
I had a similar problem 4 years ago and had a microdochectomy on the other breast,which showed up as duct esctasia and up til now no further problems.
Have got an appointment at the hospital on Tuesday to get the results, which hopefully will be ok. However I can't help worrying, this time that something will be wrong. I have had breast pain this time, and the whole process has been put through very quickly and treated as urgent, whereas it wasn't last time. GP urgent referral, hospital appointment 2 weeks later, follow up appointment 2 weeks later, with operation put forward as urgent and 3 weeks later. Whilst I am grateful that it is being dealt with quickly, I can't help worrying that there is a problem this time.
Only 2 days hopefully til I find out, I realise that this is really minor in comparison to what a lot of women are going through, and I'm sorry, but I'm getting myself all worked up.
Hi,still have discharge from one nipple & what seems to be one duct,when i first found the discharge it came out when i gently sqeezed the nipple,now it comes out when i gently touch around the areola,i found small lump in early november which now feels different like the shape of the number eight,it feels like two tiny balls stuck together,hoping to see GP this week for a second opinion as worried,my mammograam & ultrasound were both negative,but i know this lumps is deffenantly a different shape/size to the shape i found in november.If you're still there Jane,how's things?
xx
Been to GP and got an appointment at the clinic for Thursday morning
hya girl detective,
I know what you are going through, i have recently have had a hadfiels procedure for having breast discharge and dilated ducts and having a high risk of breast cancer, i used to come on here last year when my twin sister was diagnosed with breast cancer, unfortunately i lost my twin sister the end of september to this awfull disease, hope you go on well and keep your chin up. xxxx
Hi Chestnut and everyone,
I'm having the duct removal on the 4th Feb. For those who have had it - I'm wondering about time off work - I'm thinking that day and the day after?
xxx
....
Hya janerc
my doctor put me on the sick for two weeks, i think you need at least a week to start feeling even normal again, but it also depends on how you feel, every one is different how they heal, good luck with the operation, hope all goes well.
mardijane. xxx
Thanks for the reply but BUGGER!
I have just started a new job and don't want to be a sick note - I had just been off for 3 months with Ovarian issues!!!
The surgeon said - just the day of the op needed off but googling the op has thrown up guidance leaflets for other hospitals talking about a week. I have underplayed it massively at work - here's hoping!
Jane
xxx
(also pretty mardi! - ha ha)
I had the same op two years ago - i.e. in as a day patient. I was back at work the next day and felt fine. It's a pretty minor op and if you're generally OK with anaesthetic, you should be fine. Good luck.
I had Hadfield’s due problem ducts and persistent abscesses. I took a week off but could have coped with a couple of days off – though I was a bit tired out. Might have been worse for me because of the problems with the infection
I discovered a watery/bloody discharge from one breast when squeezing my nipple to look at breast milk that I still have.I mentioned this at the Milton Keynes Breast Clinic when there for a follow up to calcification that was found in the other breast.The mammograms are clear but when I told them of the discharge they took a swab which they then said showed atypical cells.They want to perform surgery and make an incision under the nipple to take a larger sample.The trouble is that they have now lost my notes and several months have gone by.I do not know what to do as I have not had the discharge for some months and am wondering if I really need to go through this process.Some comments would be most helpful.Trouble is I dont quite believe there can be anything wrong,I am 56.My Docter said have the surgery as he knows someone with an aggressive type of cancer that showed itself through a bloody discharge.