The Clinical and Pathologic Aspects of Papillomatous Disease of the Breast: A Follow-up Study of 97 Patients Treated by Local Excision

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Abstract
Because of the difference of opinion that exists concerning the clinical significance of papillomatous disease of the breast as it relates to cancer and the morphology of the process, viz., papilloma vs. papillomatosis, a follow-up and histologic study was made of 97 patients treated solely by local excision, 57 of whom were followed for 10 to 18 years. This study regards microscopic and macroscopic papillomas as one process. Papillomatous disease is divided into three broad categories: arborescent, solid, and “mixed,” encompassing the terminology used in the British literature. Each of these categories is illustrated and discussed from a morphologic aspect. Of note was the high incidence of bilaterality, the contralateral occurrence of breast cancer, the association of papillomatous disease and lobular carcinoma in situ, as well as the increased risk of developing cancer in women 45 to 65 years of age with papillomatous disease, especially the “mixed” type. Papillomatous disease, like lobular carcinoma in situ, may represent an anatomic response to a carcinogenic stimulus, and it is impossible to predict the type of cancer that will develop—only that it will with increased frequency.

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