Benign breast lesion: fibrocystic change with possible ductal papilloma

Case contribution: Dr Radhiana Hassan


  • A 60-year old lady
  • Painful swelling at the left retroareolar region few days ago
  • Associated with fever
  • Went to GP, condition showed partial improvement with antibiotics
Bilateral mammogram in MLO view
Bilateral mammogram in CC view

Mammogram findings:

  • Bilaterally dense breasts (BIRADS C)
  • A low density lesion at the left retroareolar region (red arrwows).
  • No suspicious clustered microcalcification.
  • No axillary nodes enlargement.
Ultrasound of left breast

Ultrasound findings:

  • A well-defined cystic lesion at left retroareolar region.
  • There is soft tissue component within it.
  • No penetrating vessels.

FNAC result:

  • FNAC done at patho lab on 20/1/2016
  • Aspiration of 0.8 cc straw coloured fluid
  • Moderate cellularity
  • Cohesive ductal cell, round/oval nuclei
  • Scattered foamy and binucleated macrophages
  • Apocrine metaplasia, cytoplasm abundance
  • Myoepithelial cells presence
  • Stromal component shows mild nuclear pleomorphism
  • No infection features

Diagnosis: Fibrocystic changes with occasional atypical cells more towards benign, ductal papilloma cannot be ruled out

Progress of patient:

  • Refused further follow up


  • Fibrocystic changes is a benign non-neoplastic breast condition
  • It is a common entity affecting about 90% of women
  • It is usually seen in women 20-40 years, peak at or before menopause
  • Intraductal papilloma is also a benign breast condition
  • It affects the women in similar age group as mentioned above
  • Both fibrocystic changes and intraductal papilloma does not increase risk of developing breast cancer
  • However, presence of atypical cells as seen in this case can slightly increase the risk
  • Multiple intraductal papilloma is also associated with higher risk of developing breast cancer
Author: radhianahassan