Ductal carcinoma in situ of the breast arising in a solitary intraductal papilloma

Ductal disease is a broad group encompassing both benign and malignant entities which may overlap clinically and radiologically. Ductal carcinoma in situ (DCIS) is a noninvasive breast malignancy accounting for 20% of newly diagnosed breast cancer cases. It involves malignant epithelial cells confined to the duct(s). Although they are commonly diagnosed incidentally on screening mammography, DCIS may present with nipple discharge or a palpable lump. Benign diseases of the duct include intraductal papilloma and may present similarly with bloody or serous nipple discharge. Imaging evaluation will help in differentiating between the 2 entities and pathological examination will provide the final diagnosis. We present a case of a 72-year-old female who was presented with serous and bloody discharge and histology revealed intermediate grade ductal carcinoma in situ involving an intraductal papilloma.