Marzieh Mohammadi Zavieh - Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran
Farid Azmude Ardalan - Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
Farnaz Karimi - Department of Pathology, Alborz University of Medical Sciences, Alborz, Karaj, Iran
Nahid Sedighi - Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
Ramesh Omranjpour - Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran- Breast Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran
Ahmad Elahi - Department of Surgery, Alborz University of Medical Sciences, Alborz, Karaj, Iran

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.

Papillary lesion, breast, atypia