Understanding Papillomas and Nipple Discharge: A Comprehensive Overview

Question
Hi,  I am 43 years old no history of any cancers in my family.  I have had all normal mammograms with sonograms for the 3 years I have been having mammograms etc..   I had a baseline done when I was 32 at the same facility.  I have had bilateral nipple discharge only when I cause it for over 12 years and the fluid was tested 12 years ago and was completely normal.  I go have seen the top breast surgeon (family friend) Dr. Robert Derhagopian.  I have a less than 3 mm immediately beneath the skin (you can see a bluish color) directly on the nipple (not the areola ) it's mobile.  My Dr mentioned it's a blocked duct and common causes of this is debris. He wants me to use hot compresses and try to open it up but after a month electively he wants me to consider local anesthesia and remove the tiny area.  Again it is on the nipple side almost at the top of the nipple.  He says extremely rare to have discharge for 12 years and suddenly one week to the next I have a papilloma.  I do breast exams on a weekly basis and attempt to get the fluid from the nipple then too.  I stopped for 1 week or maybe two trying to get the fluid and then this appeared.  Does this sound like a papilloma or just debris?  If just debris and thoughts on how to "open" it up?  And is the procedure of local and removing the tiny area a big deal?

Answer
This is actually a question for a breast surgeon which I'm not - I'm a medical oncologist & radiation therapist. A papilloma can be checked for by a "galactogram", a mammogram with x-ray contrast injected into the discharging milk duct. A papilloma is also not a cancer. I suggest that you have a second surgical opinion.

I have some computer problems so unfortunately my reply is delayed.

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