Juvenile papillomatosis of the breast

Dr Owen Kang and Dr Yuranga Weerakkody et al.

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 2:

  • 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.

Breast imaging and pathology

Updating… Please wait.


Error Unable to process the form. Check for errors and try again.

Alert_accept Thank you for updating your details.