Intraductal papilloma of breast
ICD-10 D24.1 · ICD-11 2F30.2

Intraductal Papilloma with ADH When Open Surgical Resection Does Not Confirm Complete Removal

This protocol applies to patients with central or peripheral intraductal papilloma and co-diagnosed atypical ductal hyperplasia (ADH) on core needle biopsy (CNB) or vacuum-assisted breast biopsy (VABB), where prior open surgical resection did not achieve confirmed complete excision on imaging.

Clinical scenario

Central or peripheral intraductal papilloma with atypical ductal hyperplasia (ADH) diagnosed by CNB or VABB. Patients in this group require individual assessment; open surgical resection is the first-choice management for those with ADH.

Previous treatment — incomplete outcome

Open surgical resection was performed as the initial step. Escalation to this protocol is triggered by failure to confirm complete removal of the lesion on imaging following that procedure. The primary goal of the prior line — complete excision confirmed on imaging — was not reached.

Next-step approach (partial)

When complete resection cannot be confirmed, the protocol specifies a more extensive surgical procedure. The full scope, criteria for selection, and decision points are detailed in the structured evidence-based regimen below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1097/CM9.0000000000001533

The panel believes that patients diagnosed with central or peripheral intraductal papilloma with ADH by CNB/VABB should be treated individually according to their specific conditions.

Open surgical resection is the first choice for patients with ADH.

If the patient has a single lesion and imaging shows that it has been completely removed, follow-up monitoring can be carried out; open extended resection is recommended in cases of uncertain complete resection.

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