ENR36 Pathology of Benign, Atypical, and Stromal Diseases of the Breast

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1

polythelia

extra nipple

2

polymastia

extra breast tissue

3

amastia

no breast

4

acute mastitis

bacterial (staph aureus), neutrophils mixed with milk

5

granulomatous mastitis

secondary to systemic disease or infectious microorganisms

6

chronic mastitis

in perimenopausal breasts, infiltration of lymphocytes and plasma cells

7

squamous metaplasia of lactiferous ducts

clogs lactiferous ducts, resulting in abscess formation

8

fat necrosis

can clinically and radiographically resemble cancer (hard mass, calcifications)

9

silicone mastitis

reaction to silicon globules

10

fibrocystic change (FCC)

benign, non-neoplastic, present in up to 50% of women, cyclical pain and irregularly lumpy breasts; histologically, there are non-proliferative and proliferative versions

11

non-proliferative FCC

cyst formation, fibrosis, apocrine metaplasia

12

proliferative FCC

cyst formation, fibrosis, apocrine metaplasia, usual ductal hyperplasia (without atypia)

13

sclerosing adenosis

aggregates of acinar structure

14

radial scar

radial arrangement of dilated glands peripherally

15

atypical ductal hyperplasia (ADH)

intraductal neoplastic low grade lesion with architectural and cytologic features suggestive but not diagnostic of low grade ductal carcinoma in situ (DCIS)

16

atypical lobular hyperplasia (ALH)

some features of lobular carcinoma but not extensive enough

17

non-proliferative breast lesions

relative risk of subsequent breast cancer = 1x

18

proliferative breast lesions

relative risk of subsequent breast cancer = 1.5-2x

19

atypical breast lesions

relative risk of subsequent breast cancer = 3-5x

20

central papilloma

subareolar mass may present with clear or bloody nipple discharge, no increase in cancer risk

21

peripheral papilloma

intraductal and incidental (no mass), slight increase in cancer risk

22

gynecomastia

breast enlargement in men due to imbalance between estrogen and androgens, pathologic from cirrhosis and medications

23

galactorrhea

milky nipple discharge in men from pituitary tumor or hypothyroidism

24

fibroadenoma

most common benign tumor of breast, young (20s-30), painless, benign glands and stromal proliferation of low or at most moderate cellularity

25

phyllodes tumors

rare, biphasic, fibroepithelial tumor (like fibroadenoma), neoplastic stroma w/ benign ductal structures, variable malignant potential, widely excised or simple mastectomy w/o lymph node dissection

26

melanoma

most common malignancy to metastasize to breast tissue

27

lipoma

uncommon but can occur in the breast

28

primary breast angiosarcoma

agressive, infiltrative tumor

29

primary breast lymphoma

B-cell lymphoma

30

breast implant-associated anaplastic large cell lymphoma

rare but unique T-cell lymphoma of the breast