Debnath Debasish, Al-Okati Dhafir, Ismail Wael
Department of Surgery, Queen's Hospital, Barking, Havering, and Redbridge University Hospitals NHS Trust, Essex RM7 0AG, UK.
Patholog Res Int. 2010 Dec 26;2010:540590. doi: 10.4061/2010/540590.
Papillary lesions of breast represent a range of lesions. Intraductal papilloma and its association with nipple discharge are well known. However, multiple papillomatosis has quite distinct characteristics and decision making can be somewhat challenging. We report a case of multiple papillomatosis in association with ductal carcinoma in situ (DCIS). Patient opted for ipsilateral mastectomy and prophylactic mastectomy of contralateral breast. Her decision of having prophylactic mastectomy was vindicated by presence of incidental DCIS in the contralateral breast. To our knowledge, this is the first reported case of multiple papillomatosis with DCIS of breast, along with incidental synchronous papillomatosis of contralateral breast with DCIS. The case illustrates few distinct features of multiple papillomatosis of breast and exemplifies how a patient's choice is so paramount in decision making process. Patients should be fully informed of the treatment options of the condition, and their wishes should be fully taken into account while making the final decision.
乳腺乳头状病变包含一系列病变。导管内乳头状瘤及其与乳头溢液的关联是众所周知的。然而，多发性乳头状瘤具有相当独特的特征，决策可能会有些挑战性。我们报告一例多发性乳头状瘤合并导管原位癌（DCIS）的病例。患者选择了同侧乳房切除术及对侧乳房预防性乳房切除术。对侧乳房偶然发现DCIS证明了她进行预防性乳房切除术的决定是正确的。据我们所知，这是首例报道的乳腺多发性乳头状瘤合并DCIS，以及对侧乳房偶然同时存在乳头状瘤合并DCIS的病例。该病例说明了乳腺多发性乳头状瘤的一些独特特征，并例证了患者的选择在决策过程中是多么至关重要。应让患者充分了解该疾病的治疗选择，在做出最终决定时应充分考虑他们的意愿。
