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.
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 containning 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.
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 prominant intraductal pattern.
May show a multiple irregular filling defects within the breasts.
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.
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.
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- 2. Mussurakis S, Carleton PJ, Turnbull LW. Case report: MR imaging of juvenile papillomatosis of the breast. Br J Radiol. 1996;69 (825): 867-70. doi:10.1259/0007-1285-69-825-867 - Pubmed citation
- 3. Hidalgo F, Llano JM, Marhuenda A. Juvenile papillomatosis of the breast (Swiss cheese disease) AJR Am J Roentgenol. 1997;169 (3): 912. - Pubmed citation
- 4. Chung EM, Cube R, Hall GJ et-al. From the archives of the AFIP: breast masses in children and adolescents: radiologic-pathologic correlation. Radiographics. 29 (3): 907-31. doi:10.1148/rg.293095010 - Pubmed citation
- 5. Sabate JM, Clotet M, Torrubia S et-al. Radiologic evaluation of breast disorders related to pregnancy and lactation. Radiographics. 2007;27 Suppl 1 : S101-24. doi:10.1148/rg.27si075505 - Pubmed citation
- 6. Kersschot EA, Hermans ME, Pauwels C et-al. Juvenile papillomatosis of the breast: sonographic appearance. Radiology. 1988;169 (3): 631-3. Radiology (abstract) - Pubmed citation
- 7. Rosen PP, Cantrell B, Mullen DL et-al. Juvenile papillomatosis (Swiss cheese disease) of the breast. Am. J. Surg. Pathol. 1980;4 (1): 3-12. - Pubmed citation
- 8. Rosen PP, Holmes G, Lesser ML et-al. Juvenile papillomatosis and breast carcinoma. Cancer. 1985;55 (6): 1345-52. - Pubmed citation
- 10. Rosen PP, Kimmel M. Juvenile papillomatosis of the breast. A follow-up study of 41 patients having biopsies before 1979. Am. J. Clin. Pathol. 1990;93 (5): 599-603. - Pubmed citation
- 11. Al sarakbi W, Worku D, Escobar PF et-al. Breast papillomas: current management with a focus on a new diagnostic and therapeutic modality. Int Semin Surg Oncol. 2006;3 : 1. doi:10.1186/1477-7800-3-1 - Free text at pubmed - Pubmed citation
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Juvenile papillomatosis of breast||✗|
|Swiss cheese disease of the breast||✓|
|Juvenile papillomatosis (JP) of the breast||✗|
|usual duct hyperplasia||✗|