Question: I had a mammogram and then a ductogram which showed an abnormality just beneath my nipple. They performed a core biopsy which showed “an atypical papilloma; no definitive ductal carcinoma in situ.” My surgeon told me I need an excision but it may mean removing my nipple. I’d rather not do this unless there really is a chance I could have cancer. Do you know what this term atypical papilloma is?

Answer: Yes, atypical papilloma usually refers to an intraductal papilloma that contains atypical ductal hyperplasia (ADH). When ADH involving a papilloma is present on a core biopsy, studies have shown that there is a risk of finding a more significant lesion on surgical excision, such as ductal carcinoma in situ or even invasive carcinoma. Unfortunately, many of these papillary lesions are beneath the nipple and thus the surgeon may have to remove the nipple to make sure the entire area is removed to rule out a cancer.