intraductal papilloma needs to be differentiated from intraductal papillary carcinoma and ductal ectasia syndrome.
(1) of breast intraductal papilloma and intraductal papillary carcinoma of breast: both see spontaneous, painless bloody nipple discharge; palpated areola lump, and pressing the lump in the opening of spill hemorrhagic liquid from the milk tube. Because of their clinical manifestations and morphological characteristics are very similar, so the differential diagnosis is very difficult. It is generally believed that the nipple discharge of breast intraductal papilloma can be bloody, it can also be serous or serous, while the nipple discharge is more common in the patients with papillary carcinoma.
papillary tumor mass beneath the areola, soft texture, mass less than 1cm, ipsilateral axillary lymph node enlargement; and papillary carcinoma of the tumors located in the areola area, hard texture, smooth surface, poor activity, and easy skin adhesion, mass general more than 1cm, the same axillary lymph node visible.
galactograms showed the catheter stump was suddenly interrupted, smooth cup shape, proximal duct showed obvious expansion, sometimes as a round or oval filling defect, soft catheter, finishing, multiple intraductal papilloma; if the irregular broken ends, the proximal catheter dilation, twisted, disordered filling defect or complete obstruction, catheter loss of natural softness and become stiff, mostly intraductal carcinoma. Smear cytology can find cancer cells in papillary carcinoma. The final diagnosis should be based on the pathological diagnosis, and paraffin sections should be taken to avoid the false negative or false positive results.
(2) of breast intraductal papilloma and ductal ectasia syndrome: hydrorrhea intraductal papilloma and ductal ectasia syndrome have nipple discharge as the main symptom, but dilatation syndrome often accompanied by congenital nipple, nipple discharge were porous, of the shape is watery milk samples, serum sample, purulent or bloody; papilloma and dilatation syndrome can be seen subareolar lump mass, but the latter were often more than the former, and the mass of irregular shape, texture hard and tough, and skin adhesion, often swollen and pain, in later stage collapse breaking and discharging.
duct ectasia syndrome can also be seen in patients with axillary lymph node enlargement, tenderness. Galactograms showed a sudden interruption of regular catheter, filling defect, for papilloma; if the larger vessels were dilated, catheter uneven thickness, the dendritic shape loses the normal rules, many dilatation syndrome. If necessary, aspiration cytology or biopsy.
(internship editor: Zheng Yanjun)