1. Breast pathology is one of the most worrying and concurrent reasons in women, where benign or malignant tumors are found.
1.1. Clinical Aspects
1.1.1. Early detection and screening for breast cancer
1.1.1.1. Diagnostic and screening tests
1.1.1.1.1. Self-examination
1.1.1.1.2. Clinical breast examination
1.1.2. 1. Fibroepithelial tumors: * Fibroadenoma * Phyllodes tumor (benign, borderline, malignant) * Breast hamartoma (adenofibrolipoma) 2. Myoepithelial lesions: * Intraductal / periductal myoepitheliosis * Adenomyoepithelial adenosis * Benign adenomyoepithelioma 3. Epithelial tumors: * Intraductal papillary neoplasms * Benign epithelial proliferations * Radial scars / complex sclerosing lesions 4. Mesenchymal tumors: * Benign vascular tumors * Lipomas: Angiolipoma * Neural line tumors * Leiomyomas * Myofibroblastomas * Granular cell tumors 5. Tumors of the nipple: * Adenoma of the nipple
1.1.3. Histological classification of breast lesions
1.1.3.1. They are ovoid or rounded masses with liquid inside and that are formed at the ducto-lobular junction.
1.1.4. Condiciones patológicas más frecuentemente encontradas en patología mamaria
1.1.4.1. Fibroadenoma
1.1.4.1.1. Fibroadenoma is part of biphasic tumors, tumors that receive their name because they have both an epithelial and a stromal component.
1.1.4.2. Fat necrosis
1.1.4.2.1. Fat necrosis appears as a painless mass of superficial location in patients with a surgical or traumatic history on the mammary gland.
1.1.4.3. Apocrine metaplasia
1.1.4.3.1. Apocrine glands are normally present in the skin of the groin, armpit, and anorectal region, but are not a constituent of the normal microscopic anatomy of the mammary gland.
1.1.4.4. Ductal hyperplasia of the usual type
1.1.4.4.1. It is an epithelial cell proliferation within the lumen of a duct without visible atypical lesions.
1.1.4.5. Papilloma
1.1.4.5.1. They are benign tumors that arise from the epithelium of the mammary ducts. They occur most frequently within or within the terminal lactiferous ducts in the central part of the breast behind the nipple -areola complex.
1.1.4.6. Hamartoma
1.1.4.6.1. It is a benign breast tumor, it presents with a well-defined mass from the point from a clinical and imaging point of view. It is composed of ducts, lobes, fibrous stroma and adipose tissue in different proportions
1.1.4.7. Complex sclerosing lesions
1.1.4.7.1. These are proliferative lesions that are characterized by a starry or stellate appearance. spiculated on mammography, which can be confused with a malignant process. Since they appear as incidental findings, they are not detectable on clinical examination
1.1.4.8. Adenosis esclerosante
1.1.4.8.1. These are proliferative lesions that are characterized by a starry or stellate appearance. spiculated on mammography, which can be confused with a malignant process. Since they appear as incidental findings, they are not detectable on clinical examination
1.1.4.9. Atypical hyperplasia
1.1.4.9.1. It includes both atypical lobular hyperplasia and atypical ductal hyperplasia. It is usually an incidental finding on a screening mammogram and its diagnosis is purely histological. These lesions are associated with a high risk of breast cancer (3.7 to 5.3 times). The risk applies to both ipsilateral and contralateral breast cancer.
1.1.5. ENDOCRINOLOGÍA DE LA MAMOGÉNESIS Y LACTANCIA
1.1.5.1. EMBRYO PERIOD
1.1.5.1.1. In Morris syndrome, for example, the inability of androgens to act, causes a functionally normal adult breast tissue to be produced, by preventing the male pattern of breast development
1.1.5.2. NEONATAL PERIOD
1.1.5.2.1. The breast nodules at that time appear the same regardless of sex. After a year there seem to be certain sexual differences, but histological studies have not been able to show them between 3 weeks and two years. The development, size and discharge of the mammary nodule will depend on:
1.1.5.3. PREPUBERAL PERIOD
1.1.5.3.1. The breast, like the hypothalamic-pituitary-gonadal axis, remains quiescent until puberty. The response to estrogens near puberty will be different between boys and girls, probably due to endocrinely determined patterns of tissue differentiation at the end of the fetal period and first months of neonatal life.
1.1.5.4. PUBERTY
1.1.5.4.1. Marshall and Tanner described the 5 stages of breast development that are completed between 1.5 and 6 years during puberty. There is an increase in size, morphological alteration, nipple erection, together with ductule canalization, and, above all, an increase in connective tissue and fatty filler in a quantity much higher than that of glandular tissue.
1.1.5.5. ADULT MOM
1.1.5.5.1. The breast is a target organ for cyclical fluctuations in gonadotropins, sex steroids, and PRL. This causes changes, some clinically evident and others only in the laboratory.
1.1.5.6. PREGNANCY
1.1.5.6.1. In early pregnancy, acini develop at the end of the ductal tree
1.1.5.6.2. Towards the middle of pregnancy, the lobe-acinar units increase in number and size.
1.1.5.6.3. Colostrum secretion appears later
1.1.5.6.4. The influence of different hormones on the pregnant breast is manifested differently
1.1.5.7. LACTATION
1.1.5.7.1. The breast is capable of secreting milk in the second trimester of pregnancy, although of a different composition than the final one