A 39-year-old woman reports intermittent serosanguineous discharge from one nipple for three months. There is no palpable mass and mammography is normal. A small subareolar nodule is identified on ultrasound. Histology of the excised lesion shows a branching fibrovascular core covered by benign dual-layered epithelium within a dilated duct. Which statement about this lesion is correct?

• A It carries a high lifetime risk of subsequent invasive carcinoma
• B It is almost always bilateral
• C It arises most often in the terminal duct lobular unit
• D It is the commonest cause of bloody nipple discharge in women below 50 years ✓

Explanation

Solitary intraductal papilloma of the large lactiferous duct near the nipple is the classic cause of bloody or serosanguineous nipple discharge in premenopausal women. It is usually solitary and unilateral, killing option B. It arises in large ducts, not the terminal duct lobular unit (option C). A solitary papilloma without atypia does not confer a significantly increased cancer risk, which distinguishes it from multiple papillomas and juvenile papillomatosis, so option A is false.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.