Bilateral Juvenile Papillomatosis of Breast-a Rare Case Report

Juvenile papillomatosis (JP) of breast is a rare benign proliferative disease of the female breast which can be seen in women younger than 30 years of age. They usually present with a mobile lump in the breast, which can be easily mistaken clinically for a fibroadenoma. A 16-year-old girl presented to our outpatient with history of nipple discharge from the left breast which she noticed 1.5 years back. The discharge was occasionally blood stained. Physical examination revealed multiple diffuse mobile lumps in both the breasts. Imaging and core needle biopsy were suggestive of juvenile papillomatosis. Hence, USG-guided wire localization and excision of the affected ductal system was planned. Gross and microscopic sections were also confirmative of juvenile papillomatosis. Our patient was an unusual case of juvenile papillomatosis presenting with nipple discharge and bilateral multiple breast lumps with no family history. An ideal treatment for juvenile papillomatosis should be wide local excision with careful watch (Rosen PP et al., Am J Surg Pathol 4(1):3-12, 1980). Due to extensive disease in both breasts, a complete excision would have led to mastectomy. In the absence of consent for mastectomy, the present patient was treated by wide local excision of the involved duct only without any adjuvant treatment. She was counselled and warned for regular close follow-up. It was emphasised that she should undergo a risk-reducing bilateral mastectomy once she has had completed her family.