Large breast lump with bloody nipple discharge: benign intraductal papilloma

A 32-year-old woman presented with a 3 cm×3 cm left breast lump associated with bloody nipple discharge during her early pregnancy. Examination and ultrasonography showed benign features, whereas core needle biopsies revealed a benign papilloma. Six months after her delivery, a 6 cm×6 cm benign papilloma was completely excised via circumareolar incision. The majority of intraductal papillomas are small; however, they can also present as a large mass rarely. We should be wary of a malignant papillary lesion when there is the presence of atypia on core needle biopsy or imaging-histology discordance. A concordant benign papilloma with benign imaging findings is otherwise reassuring. Clinicians need to be aware of this uncommon presentation of large intraductal papilloma as a complete curative excision can be achieved through a cosmetically placed incision.