Papillary duct hyperplasia of the breast in children and young women.

Seventy-four patients who had papillary duct hyperplasia were studied to characterize the pathologic features of the lesions and to assess their precancerous significance. All but one were female. The median age at diagnosis was 17 yr with 52 (70%) between 15 and 25 yr, 18 (24%) < 15 yr and four (5%) 25 to 29 yr old. Age at follow-up ranged from 9 to 53 yr with 49 (66%) < 30 yr, 22 (30%) age 30 to 39 yr, and three (4%) age 40 yr or more. Median age at last follow-up was 28 yr. The most frequent presenting symptoms were a mass and/or nipple discharge. A family history of breast carcinoma was reported by 19 of 69 patients (28%) with available information. Three patterns of papillary duct hyperplasia were identified: sclerosing papilloma (31; 42%), papilloma (24; 32%) and papillomatosis (19; 26%). Prominent cysts, apocrine metaplasia, other benign proliferative changes, and mastitis that characterize juvenile papillomatosis were absent. All patients had an excisional biopsy followed by segmental mastectomy for two large lesions. Recurrences in the breast were detected in 12 (16%) of the patients after a median interval of 3 yr, more commonly in patients with sclerosing papilloma (5; 31%) and papilloma (5; 21%) than in those with papillomatosis (2; 11%). The risk of recurrence was not related to a family history of breast carcinoma. None of the patients developed mammary carcinoma or any other malignant neoplasm. These results indicate that children, adolescents, and young women with the types of papillary duct hyperplasia described in this report are not predisposed to develop breast carcinoma before age 30.(ABSTRACT TRUNCATED AT 250 WORDS)