OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is intraductal papilloma. While this may seem a odd practice, it is useful to see multiple examples of how intraductal papilloma will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
QUESTION EXAMPLES
Question # 1
A 43 year old woman comes to the office with complaints of having blood stains on the right side of her bra. She is very concerned because her 69 year old mother was recently diagnosed with breast cancer. The patient performs self breast exams and has not felt any lumps. She denies noticing any bleeding from the left breast. Her past medical history is notable for type 2 diabetes, for which she takes insulin and metformin. She denies smiling cigarettes, and only drinks alcohol on some rare occasions. Her physical exam shows no palpable breast masses. Mammography is performed and there are no masses of calcifications visualized. What is the most likely diagnosis?
Explanation: pathological discharge (unilateral bloody) + no palpable breast mass + nothing on mammography = intraductal papilloma
Question # 2
A 50 year old woman is undergoing a workup for discharge from her left nipple. She first noticed this last week during a self examination. Her history is notable for schizophrenia, which she was diagnosed with in her 20s. She has been well controlled with antipsychotic therapy. She takes acetaminophen at times for headaches. She runs and plays golf regularly. She denies using tobacco, alcohol, or any illicit drugs. Her family history is notable for a paternal aunt who died from metastatic breast cancer at the age of 49. Her temperature is 98.2°F. Her physical exam is notable for 1 mL of reddish/brown fluid that is expressed form her left breast. No masses or lymphadenopathy is present when the physician palpates. What is the most likely cause of this patient’s presentation?
Explanation: pathological discharge (unilateral bloody) + no palpable breast mass = intraductal papilloma
Question # 3
A 50 year old perimenopausal woman comes to the clinic with complaints of nipple discharge. She explains that she has been experiencing intermittent discharge from her left nipple for he past 3 months. During the physical exam the physician is able to visualize some serosanguineous discharge from only the left nipple. No mass is palpable. A screening mammography is conducted and is within normal limits. What is the most likely diagnosis in this patient?
Explanation: unilateral discharge + no palpable breast mass + normal mammography = intraductal papilloma
Question # 4
A 45 year old woman who is G2P2 comes to the clinic because she has been noticing a bloody discharge from her left nipple for the past 2 months. She has a family history of breast cancer (her mother died of breast cancer at age 65). A clinical breast exam reveals bloody discharge that can be expressed with pressure on the left areola. No masses are palpated. There is no lymphadenopathy present. A mammogram is unremarkable. What is the most likely diagnosis in this patient?
Explanation: unilateral bloody discharge + no breast mass + no findings on mammography = intraductal papilloma
Question # 5
A 45 year old woman comes to the clinic because she has noticed a rust colored discharge on one side of her bra. Her past medical history is unremarkable and she does not take any medications. She has no family history of breast cancer. Her vital signs are within normal limits. A clinical breast exam shows no abnormalities and no discharge can be expressed form her nipples. What might the diagnosis be?
Explanation: pathological unilateral discharge + no palpable masses = intraductal papilloma
Question # 6
A 35 year old woman comes to the clinic with copouts of bloody discharge from her left nipple. This has been occurring on and off for several months. On physical examination there is no palpable mass.
Explanation: unilateral bloody discharge + no palpable masses = intraductal papilloma
Question # 7
A 29 year old woman coms to the clinic with complaints of bloody discharge from her right breast that she has been notching on and off for the past 5 weeks. She denies every feeling any palpable mass, and does not have any weight loss, fevers, chills, or night sweats. She has no personal or family history of breast cancer. A physical exam reveals normal appearing breasts bilaterally with no remarkable skin findings. There is no breast mass palpable, and there is no axillary lymphadenopathy. An ultrasound does not reveal any findings. What is the likely diagnosis in this patient?
Explanation: unilateral bloody discharge + no breast mass + no findings on ultrasound = intraductal papilloma
Page Updated: 10.18.2016