Faculty of Allied Medical Sciences Histopathology and Cytology (MLHC-201)

BREAST PATHOLOGY Supervision : Prof. Dr. Noha Ragab

Intended Learning Outcomes By the end of this lecture the student should know By the end of this lecture the student should know 1-the different proliferative and non-proliferative breast lesion 2-The types of different inflammations 3-The different benign breast tumours

NORMAL BREAST

Normal breast tissue Breast lobules Main duct

Fibrocystic diseases of breast

Fibrocystic changes: Clinical presentation: Clinical presentation: Produce palpable “ lumps ” Produce palpable “ lumps ” They may cause nodularity They may cause nodularity

Fibrocystic diseases: They can be subdivided into non-porliferative and proliferative patterns. They can be subdivided into non-porliferative and proliferative patterns.

Non-proliferative fibrocystic change Cysts and fibrosis: Cysts and fibrosis: Characterized by an increase in fibrous stroma associated with dilation of ducts and formation of cysts of various sizes. Characterized by an increase in fibrous stroma associated with dilation of ducts and formation of cysts of various sizes.

Fibrocystic changes of breast

Proliferative fibrocystic change Epithelial hyperplasia: Epithelial hyperplasia: It is proliferative lesion within the ductules, the terminal ducts and sometimes the lobules of the breast. It is proliferative lesion within the ductules, the terminal ducts and sometimes the lobules of the breast. Sclerosing adenosis: Sclerosing adenosis: This variant is less common, but it is significant because its clinical features are similar to those of carcinoma. This variant is less common, but it is significant because its clinical features are similar to those of carcinoma.

Sclerosing adenosis Epithelial hyperplasia

FIBROCYSTIC DISEASES OF BREAST NON-PROLIFERATIVE FIBROCYSTIC DISEASE PROLIFERATIVE 1.EPITHELIAL DUCT HYPERPLASIA 2.SCLEROSING ADENOSIS CYSTS FORMATION ANDFIBROSIS

Inflammations of breast

1. Acute mastitis 2. Fat necrosis 3. Mammary duct ectasia

Fat necrosis: Often related to trauma Often related to trauma Produce a palpable mass Produce a palpable mass

Acute mastitis: Common during lactation Common during lactation They usually cause pain and tenderness in the involved areas. They usually cause pain and tenderness in the involved areas. They are not associated with increased risk of cancer. They are not associated with increased risk of cancer.

Mammary duct ectasia: Granulomatous reaction; this generally follows acute mastitis and is a localized granulomatous reaction. In some instances associated with ectasia of the ducts (cystic dilatation) Granulomatous reaction; this generally follows acute mastitis and is a localized granulomatous reaction. In some instances associated with ectasia of the ducts (cystic dilatation) Encountered in women in their 40s and 50s. Encountered in women in their 40s and 50s. Mammary duct ectasia leads to hardness of the breast substance mimicking the changes caused by carcinoma. Mammary duct ectasia leads to hardness of the breast substance mimicking the changes caused by carcinoma.

Tumors of the breast

Benign tumors of breast

Fibro adenoma Fibro adenoma Phylloids tumour Phylloids tumour Intra ductal papilloma Intra ductal papilloma

Fibroadenoma Most common benign neoplasms of the female breast. Most common benign neoplasms of the female breast. Almost never become malignant. Almost never become malignant. Peak incidence is in the third decade of life. Peak incidence is in the third decade of life. Presents as a solitary, discrete, movable mass. Presents as a solitary, discrete, movable mass.

Microscopically:

Fibroadenoma

Phylloids tumour Much less common than fibroadenomas. Much less common than fibroadenomas. Arise from the periductal stroma and from preexisting fibroadenomas. Arise from the periductal stroma and from preexisting fibroadenomas. On gross section they exhibit leaf-like clefts and slits, that is why they called phylloids tumors. On gross section they exhibit leaf-like clefts and slits, that is why they called phylloids tumors. Microscopically: increased cellularity and stromal overgrowth Microscopically: increased cellularity and stromal overgrowth

Phyllodes tumor

Intra-ductal papilloma A benign neoplastic papillary growth within a duct. A benign neoplastic papillary growth within a duct. Solitary and found within the principal lactiferous ducts or sinuses. Solitary and found within the principal lactiferous ducts or sinuses. Microscopically: benign papillary growth within a main lactiferous duct Microscopically: benign papillary growth within a main lactiferous duct

Clinically: Clinically: Appearance of serous or bloody nipple discharge Appearance of serous or bloody nipple discharge Presence of small sub-areolar tumour Presence of small sub-areolar tumour

Intra-ductal papilloma

Questions Complete : 1- Fibrocystic diseases can be subdivided into ……… 2- The inflammations of the breast include ……… 3- The benign tumors of the breast include ……… 4- The most common benign neoplasms of the female breast are ……….. 5- Principal lactiferous ducts or sinuses exhibit the growth of …….

Assignments Rheumatic fever أمل رأفت محمد امنية بدوي أحمد نعينع امنية صبري محمد الجمل Hypertension امنية عبد الحي عبد الوهاب محمد علي أميرة رفعت حسن علي أحمد أميرة صلاح الشحات ابراهيم حسين

Thank You