Papillary Lesion of the Breast in a Young Girl Suspicious to Juvenile Papillomatosis, Clinical Decision Making in a Multi-disciplinary Team and Review of the Literature

Background: Papillary lesions of the breast are a heterogeneous group ofneoplasms, the diagnosis and treatment of which is challenging. Typically surgicalexcision is recommended for papillary lesions after core needle biopsy (CNB) torule out concurrent malignancy when a diagnosis of papilloma with atypia isyielded on CNB. For papilloma without atypia, however, making a decision aboutexcision versus observation is challenging. Case Presentation: A ۱۴-year-old female with nipple discharge, and a ۲ cm mass in the right breast, with the pathology of intra-ductal papilloma withoutatypia on CNB presented. The question to be answered by multi-disciplinary teamwas the best management of this papillary lesion and whether the follow up wasadequate or excision was mandatory. Question: What is the best plan for management of the young patient accordingto the primary pathology report of Juvenile Papillomatosis? Conclusion: Histoathology review of CNB specimen in rare and high risk lesions may have some advantages. On the other hand, in high risk circumstances,the excision of the lesion is recommended. Thus, in this case, the multidisciplinaryteam recommended excision of the lesion.

Keywords:

Papillary lesion , breast , atypia