BENIGN BREAST LESIONS Flashcards
Inflammatory/Infectious Disorder
- Most common during postpartum period
- Nursing-related cracks and fissures in nipples
- Pain, erythema, swelling, warmth, unilateral
- # 1 Staphylococcus aureus, #2 streptococci
- Localized acute inflammation which may progress to form single or multiple abscesses
- Continue breastfeeding
Acute Mastitis
Inflammatory/Infectious Disorder
- Painful, erythematous subareolar mass
- Smoking history
- Keratinizing squamous epithelium extends deep within major ducts
- Trapped keratin causes duct dilatation, rupture, and chronic granulomatous reaction
- Periareolar fistula, fibrous scarring, nipple inversion
- Removal of entire portion of keratinizing epithelium
Periductal Mastitis
Inflammatory/Infectious Disorder
• Multiparous women in 5th or 6th decade
• Poorly-defined subareolar mass with overlying skin
retraction
• Thick, cheesy nipple discharge
• Dilation of ducts due to inspissated secretions
• Marked periductal and interstitial chronic granulomatous inflammation
• May be mistaken clinically or mammographically as
cancer
Mammary Duct Ectasia
Inflammatory/Infectious Disorder
• Clinically presents with palpable mass lesion
• Often history of trauma, prior surgery, or radiation
• Grossly well-demarcated, bright yellow lesion
• Acute: necrotic fat, lipid-laden macrophages, and neutrophils
• Chronic: macrophages, foreign-body giant cells,
lymphocytes, and fibrosis
• Calcifications common
• Mimics cancer radiographically and with palpation
Fat Necrosis
name this fat necrosis
necrotic fat, lipid-laden macrophages, and neutrophils
Acute
name this fat necrosis
macrophages, foreign-body giant cells, lymphocytes, and fibrosis
Chronic
• Single most common disorder of female breast
• 60-80% incidence in autopsy studies
• Etiology possibly related to hormonal imbalance
• Most often diagnosed in 20-40 year olds
• Wide variety of morphologic features
• Mimics CA by producing palpable lumps, mammographic densities, calcifications, and
nipple discharge
Fibrocystic Changes
what are the fibrocystic changes?
cyst formation
fibrosis
adenosis
apocrine metaplasia
name this fibrocystic change
multifocal & bilateral
Cyst formation
name this fibrocystic change
secondary to cyst rupture,
produces palpable firmness
Fibrosis
name this fibrocystic change
increased # acini per lobule
Adenosis
Proliferative Breast Disease
- Grossly hard with cartilaginous consistency
- Increased number of acini per lobule
- Central acini are distorted and compressed
- Peripheral acini are dilated
- Varying degrees of intralobular fibrosis
- Lobular architecture maintained
Sclerosing Adenosis
Proliferative Breast Disease
- Increase in number of cell layers (>2 cell layers)
- Heterogeneous cell population
- Cells fill up duct lumen often forming slit-like spaces at the periphery (fenestrations)
Usual Ductal hyperplasia (UDH)
Proliferative Breast Disease
• Close resemblance to DCIS or LCIS but does not
fulfill criteria for malignancy
• 5-10% of patients with proliferative breast disease
Atypical Ductal/Lobular hyperplasia (ADH/ALH)
***Fibrocystic changes: Are they malignant?
Cysts, adenosis, apocrine metaplasia, mild epithelial
hyperplasia
what is this risk?
Minimal risk
