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Revista Colombiana de Cirugía

Print version ISSN 2011-7582On-line version ISSN 2619-6107


TORREGROZA-DIAZGRANADOS, Eduardo  and  GOMEZ, María Constanza. Intraductal papillary tumors of the breast. rev. colomb. cir. [online]. 2010, vol.25, n.2, pp.131-150. ISSN 2011-7582.

Introduction: intraductal papillary tumors of the breast are a heterogeneous group of lesions characterized by a papillary configuration in macroscopic or microscopic examination or both. Objectives: To characterize the main intraductal papillary tumors of the breast in relation to its main clinical manifestations, pathological characteristics and diagnostic methods of detection. Materials and Methods: During 6 years of continuous and systematic manner the authors recorded information of 72 patients with intraductal papillary tumors of the breast. All patients with nipple secretion were candidates for resection of terminal ducts if they met the following clinical criteria: nipple discharge spontaneous, unilateral, persistent, o nipple serous secretion (such as water rock) or hemorrhagic. Patient whose clinical manifestation was the presence of palpable mass, management algorithm was based on the triple diagnostic approach. A finding discordant between clinical and radiological-pathological, we recommended complete resection of the lesion. Results: Benign papillomas were type of breast intraductal tumor papillary most frequent followed by non-invasive papillary carcinomas and atypical papillomas subsequently. Nipple secretion hemorrhagic manifestation was the most frequent of intraductal papillary tumors and was critical to the surgical diagnosis. Most benign intraductal papillomas were single. Conclusion: Clinical history and physical examination were the cornerstone for the diagnosis of intraductal papillary tumors of the breast. Total duct excision is idicated in presence of nipple discharge spontaneous, unilateral, persistent, o nipple serous secretion (such as water rock) or hemorrhagic, even, when mammography and breast ultrasound are reported as normal. In the presence of a palpable mass, the ideal evaluation is of triple diagnosis approach. Close collaboration between surgeon and breast disease is vital to proper management of these lesions.

Keywords : neoplasms; ductal; lobular; and medullary; papilloma; intraductal; carcinoma; papillary; carcinoma; intraductal; noninfiltrating.

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