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Juvenile papillomatosis of the breast

Juvenile papillomatosis (JP) of the breast is a relatively common benign localised proliferative lesion in the breast.


As the name implies, it is mainly seen in young women (mean age ~19-23 years 4,6) and is unusual in women over 30 years old. 

Clinical presentation

Patients present with a firm, well-defined, mobile mass often in the periphery of the breast. There is usually no nipple discharge.


Juvenile papillomatosis is a papillary proliferation of the ductal epithelium which partly fills up smaller ducts and distends them to a degree. Gross pathology often shows a well-circumscribed mass containing multiple small cysts (< 2 cm) within a dense fibrous stroma (therefore sometimes termed Swiss cheese disease by pathologists). Lesions can vary in size, usually ranging from 1 to 8 cm. 

Radiographic features

Breast ultrasound

They can appear as an ill-defined, inhomogenous hypoechoic mass with multiple small (up to 4 mm) predominantly peripheral cysts. Microcalcifications may be seen at sonography 5.


These lesions are usually negative on mammography 4-5. Occasionally mammograms may show pleomorphic or amorphous microcalcifications, an asymmetric density or a prominent intraductal pattern. 


May show a multiple irregular filling defects within the breasts.

Breast MRI

Signal characteristics according to one report include :

  • T1:  hypo-intense lobulated mass
  • T2:  may show presence of multiple small internal cysts, best shown on this sequence and is considered the most specific feature
  • T1 C+ (Gd):  may or may not show marked rapid enhancement 11
  • dynamic sequence:  shows a benign enhancement profile

Treatment and prognosis

Despite being a benign entity, it is considered by some to be a marker for familial breast cancer. Approximately 10%10 of those with papillomatosis are thought to develop breast cancer later in life.

Related articles

Breast imaging and pathology

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