How are papillomas managed?

Papillomas are heterogeneous on pathology and can contain areas of atypia and DCIS missed by image-guided biopsies (sample error)
Small (Larger (>1cm) or papillomas with concerning imaging features can be excised to avoid missing areas of atypia or DCIS
Any papilloma with atypia on image-guided biopsy should be excised due to a reported upgrade rate of 70% to cancer on excision