Low-grade tumours recur locally but metastasise only rarely. In contrast high-grade tumours behave aggressively with local recurrences as well as distant metastases. This refers to a neoplastic proliferation within the duct system and which has a papillary growth pattern. These tumours arise within the large ducts of the nipple and patients usually present with a nipple discharge. They are usually small and less than 1 cm in dimension.
Local excision is curative.
Solitary papillomas do not have any sinister significance however multiple intraductal papillomas which are a distinct from the solitary variety, are associated with an increased risk of subsequent malignancy. These are uncommon in clinical practice. Note the fibrovascular cores with overlying epithelium. The two epithelial cell layer is retained. Breast carcinoma Breast cancer is the commonest malignancy in women within the western world.