Female breast pathology

This is a brief video on neoplastic and nonneoplastic diseases of the breast in females (excluding gynecomastia)

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ADDITIONAL TAGS:
Breast pathology
Neoplastic and nonneoplastic diseases of the breast in females
Fibroadenoma
Phyllodes tumor
Fat necrosis
Acute mastitis
Periductal mastitis
Mammary duct ectasia
Fibrocystic changes
Intraductal papilloma
Ductal carcinoma in situ
Paget disease
Invasive ductal carcinoma
Lobular neoplasia
Invasive lobular carcinoma
Benign conditions
Malignant conditions
Def: Noncancerous breast tumor consisting of stromal and epithelial tissues
Epi: women in 20s to 30s, most common benign neoplasm
Clinical: painless, firm, rubbery, mobile lump
might enlarge based on menstrual cycle (estrogen-sensitive)
Gross: solid, lobulated, tan/pink, firm, no necrosis, no hemorrhage; well-circumscribed
US: solid, round, homogenous mass; well-circumscribed
Histo: gland structures with stromal and ductal proliferation, no cytologic atypia
Phyllodes tumor
AKA cystosarcoma phyllodes, cystosarcoma phylloides and phylloides tumor
Def: Masses arising from stromal cells surrounding ducts of the breast
Fibrous neoplasia pushes out tissue→ gross and histologic changes
Epi: older (40+ and postmenopausal), African American, rare tumor
Clinical: large mass, bulky, mobile, firm as a “wooden log†-- twice as large as the other breast
Gross: blue veins on skin surrounding tumor, well-circumscribed
Histo: fibrous gland and tissues with intermittent cystic spaces, epithelial leaf-lined structure; cytologic atypia and mitotic figures are rare
Spread: might recurs after excision, 5-10 percent undergo malignant transformation
Treatment: excise surgically (wide local excision or mastectomy)
Fat necrosis
AKA fatty lumps
Def: normal fat cells of the breast become round lumps through necrosis
Caused by trauma, radiation, or surgery involving breast
Epi: women post trauma, radiation, or surgery
Clinical: painful, induration with irregular contours, retraction of skin
Mammogram: eggshell calcification (results from saponification)
Gross: necrotic fat tissue → must biopsy to rule out cancer; induration
Histo: necrotic fat with calcifications, giant cells, granulation tissue, lipid-laden macrophages
Spread: no malignant potential
Although confused with cancer bc of calcification, induration, skin retraction, irregular contours
Treatment: not necessary
Fibroadenoma
Phyllodes tumor
Fat necrosis
Acute mastitis
Periductal mastitis
Mammary duct ectasia
Fibrocystic changes
Intraductal papilloma
Ductal carcinoma in situ
Paget disease
Invasive ductal carcinoma
Lobular neoplasia
Invasive lobular carcinoma
Fibroadenoma
Phyllodes tumor
Fat necrosis
Acute mastitis
Periductal mastitis
Mammary duct ectasia
Fibrocystic changes
Intraductal papilloma
Ductal carcinoma in situ
Paget disease
Invasive ductal carcinoma
Lobular neoplasia
Invasive lobular carcinoma
Histo: necrotic fat with calcifications, giant cells, granulation tissue, lipid-laden macrophages
Acute mastitis
Def: bacterial infection of the breast
Typically caused by skin organisms Staph aureus (or Strep), when breastfeeding → stress on skin allows bacteria to enter breast
Epi: breastfeeding women
Clinical: purulent discharge from breast; warm, erythematous breast; engorgement; loss of nipple integrity
Spread: no malignant potential
dicloxacillin for beta-lactamase-producing organisms such as S aureus) and drainage
Periductal mastitis
Def: inflammation of breast tissue beneath the nipple
Epi: smokers
AKA duct ectasia of breast or plasma cell mastitis
Def: lactiferous duct becomes blocked or clogged
Inflammation of the duct leads to duct dilation → debris piles up and goes into nipple → discharge
Epi: postmenopausal, multiparous women; rare
Clinical: green/brown nipple discharge
Mammogram: typical rod-like calcifications
Histo: chronic inflammation, plasma cells
Fibrocystic changes
AKA fibrocystic breasts or fibrocystic breast disease or fibrocystic breast condition (FBC)