benign Tumors of breast

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benign Tumors of breast by Mind Map: benign Tumors of breast

1. STROMAL TUMORS

1.1. Types:

1.1.1. fibroadenoma

1.1.1.1. The most common benign tumor of the female breast

1.1.1.2. Composed of both epithelial and stromal tissue derived from the TDLU.

1.1.1.3. Clinical:

1.1.1.3.1. Any age ,most common before age 30

1.1.1.3.2. • Usually present with a palpable mass

1.1.1.3.3. • Regression usually occurs after menopause

1.1.1.3.4. It may increase in size during pregnancy and cease to grow after menopause.

1.1.1.4. Histology:

1.1.1.4.1. The tumor presents as a spherical, rubbery nodule, which is sharply circumscribed from the surrounding breast tissue and so is freely movable and can be shelled out.

1.1.1.4.2. The tumor is usually solitary but may be multiple and involve both breasts.

1.1.1.4.3. The cut surface is pearl-white

1.1.1.4.4. • Spherical nodules

1.1.1.4.5. • Sharply demarcated

1.1.1.4.6. • Freely movable

1.1.1.4.7. • Size vary

1.1.1.4.8. • Proliferation in both glands and stroma

1.1.1.4.9. Histologically, the tumor is composed of a mixture of ducts and fibrous connective tissue.

1.1.1.4.10. picture slide 40 & 41

1.1.1.5. Behavior:

1.1.1.5.1. • The tumor is completely benign.

1.1.1.5.2. • Rarely, carcinoma may arise within a fibroadenoma.

1.1.1.6. Treatment:

1.1.1.6.1. lumpectomy (only the lump is removed)

1.1.2. Phylloids tumor

1.1.2.1. Phyllodes tumors, like fibroadenomas, arise from intralobular stroma.

1.1.2.2. Clinical:

1.1.2.2.1. Although they can occur at any age, most present in the sixth decade, 10 to 20 years later than the average presentation of a fibroadenoma

1.1.2.2.2. Most present as palpable masses

1.1.2.3. Treatment:

1.1.2.3.1. Phyllodes tumors must be excised with wide margins to avoid the high risk of local recurrences.

1.1.2.4. Behavior:

1.1.2.4.1. The majority are low-grade tumors that may recur locally but only rarely metastasize.

1.1.2.4.2. Rare high-grade lesions behave aggressively, with frequent local recurrences and distant hematogenous metastases in about one third of cases.

2. Fibrocystic change

2.1. most common disorder of the breast.

2.2. Clinical:

2.2.1. Often produce palpable lumps

2.2.2. The condition is diagnosed frequently between the ages of 20 and 55 and decreases progressively after the menopause.

2.2.3. Presentation:

2.2.3.1. Fibrocystic change presents with asymptomatic masses in the breast, which are discovered by palpation.

2.2.3.1.1. The masses vary from diffuse small irregularities (lumpy bumpy breast) to a discrete mass or masses.

2.2.3.2. Pain may be focal or diffuse and may or may not be associated with the lumps

2.2.3.3. It may also present with pain, which may be cyclical with midcycle or pre-menstrual discomfort.

2.3. Characterized by various combinations of

2.3.1. fibrous overgrowth

2.3.2. cysts

2.3.3. epithelial proliferation

2.4. The cause of fibrocystic change is not known.

2.5. Three patterns of morphologic changes:

2.5.1. 1- Cyst formation

2.5.1.1. • Cysts :small to big in size ,lined by benign epithelium with apocrine metaplasia.

2.5.1.2. Histologically, cysts may be lined by flattened epithelium, columnar epithelium with features of apocrine cells or may completely lack an epithelial lining.

2.5.1.3. Semi-translucent or turbid fluid

2.5.2. 2- Fibrosis

2.5.2.1. • Fibrosis : contribute to the palpable firmness of the breast.

2.5.2.2. New Node

2.5.3. 3- Adenosis

2.5.3.1. Adenosis : Increase in the number of acini per lobule. • Adenosis can be seen in pregnancy.

3. Proliferative breast disease

3.1. proliferative Disease without Atypia

3.1.1. Clinical:

3.1.1.1. • Rarely form palpable masses

3.1.1.1.1. New Node

3.1.1.2. • Detected as mammographic densities.

3.1.1.3. • Incidental finding

3.1.1.4. • e.g.Large duct papilloma present in 80% as nipple discharge.

3.1.1.5. • Risk for cancer is 1.5 – 2 times normal

3.1.2. definition:

3.1.2.1. Proliferation of ductal epithelium and/or stroma without cellular abnormalities that are suggestive of cancer

3.1.3. Types:

3.1.3.1. Epithelial hyperplasia

3.1.3.1.1. Definition:

3.1.3.1.2. Ranges:

3.1.3.1.3. Histology:

3.1.3.2. Sclerosing adenosis

3.1.3.2.1. Clinical:

3.1.3.2.2. Histology

3.1.3.3. complex sclerosing lesions/radial scar

3.1.3.3.1. Definition:

3.1.3.3.2. Histology:

3.1.3.3.3. picture slide 25

3.1.3.4. Papillomas

3.1.3.4.1. It arises more often in the central part of the breast from the lactiferous ducts (75%) but can occur in any quadrant.

3.1.3.4.2. Histology:

3.1.3.4.3. Clinical:

3.1.3.4.4. This is a papillary tumor that arises from the duct epithelium including large ducts.

3.2. Atypical hyperplasia

3.2.1. Proliferative Breast Disease with Atpyia

3.2.1.1. Risk for cancer is 4-5 times normal

3.2.1.2. definition:

3.2.1.2.1. Atypical hyperplasia is a cellular proliferation resembling ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS) but lacking sufficient qualitative or quantitative features for a diagnosis of carcinoma in situ.

3.2.1.2.2. Atypical hyperplasia has some of the architectural and cytologic features of carcinoma in situ but lack the complete criteria for that diagnosis and is categorized as ductal or lobular in type

3.2.1.3. Tyes:

3.2.1.3.1. Atypical ductal hyperplasia.

3.2.1.3.2. Atypical lobular hyperplasia.

3.2.1.4. picture slide 33

4. Non proliferative breast changes