ENR36 Pathology of Benign, Atypical, and Stromal Diseases of the Breast
polythelia
extra nipple
polymastia
extra breast tissue
amastia
no breast
acute mastitis
bacterial (staph aureus), neutrophils mixed with milk
granulomatous mastitis
secondary to systemic disease or infectious microorganisms
chronic mastitis
in perimenopausal breasts, infiltration of lymphocytes and plasma cells
squamous metaplasia of lactiferous ducts
clogs lactiferous ducts, resulting in abscess formation
fat necrosis
can clinically and radiographically resemble cancer (hard mass, calcifications)
silicone mastitis
reaction to silicon globules
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
non-proliferative FCC
cyst formation, fibrosis, apocrine metaplasia
proliferative FCC
cyst formation, fibrosis, apocrine metaplasia, usual ductal hyperplasia (without atypia)
sclerosing adenosis
aggregates of acinar structure
radial scar
radial arrangement of dilated glands peripherally
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)
atypical lobular hyperplasia (ALH)
some features of lobular carcinoma but not extensive enough
non-proliferative breast lesions
relative risk of subsequent breast cancer = 1x
proliferative breast lesions
relative risk of subsequent breast cancer = 1.5-2x
atypical breast lesions
relative risk of subsequent breast cancer = 3-5x
central papilloma
subareolar mass may present with clear or bloody nipple discharge, no increase in cancer risk
peripheral papilloma
intraductal and incidental (no mass), slight increase in cancer risk
gynecomastia
breast enlargement in men due to imbalance between estrogen and androgens, pathologic from cirrhosis and medications
galactorrhea
milky nipple discharge in men from pituitary tumor or hypothyroidism
fibroadenoma
most common benign tumor of breast, young (20s-30), painless, benign glands and stromal proliferation of low or at most moderate cellularity
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
melanoma
most common malignancy to metastasize to breast tissue
lipoma
uncommon but can occur in the breast
primary breast angiosarcoma
agressive, infiltrative tumor
primary breast lymphoma
B-cell lymphoma
breast implant-associated anaplastic large cell lymphoma
rare but unique T-cell lymphoma of the breast