1. Dr. Amit Gupta Associate Professor Dept Of Surgery
benign breast disease
Dr. Amit Gupta
Associate Professor
Dept Of Surgery

2. Mammary ductogram demonstrating lobules

3. Pre-menarchal ductule
Terminal ductal-lobular unit

4. Breast Development Menarche and Reproductive Cycles:
Pulsed estrogen exposure causes rapid growth, elongation and branching
Term pregnancy leads to terminal differentiation and stops growth
End bud epithelial tissue undergoes cyclic proliferation
Breast feeding is associated with a lower risk of breast cancer

5. Normal breast in
pregnancy and
after

6. Breast Development
Involution: Changes of involution begin after cessation of lactation and continue through menopause
Competing involution and proliferative processes are patchy and increased in peri-menopause and with HRT
Hyperplasia with atypia and DCIS peak in this period

7. Involutional and
cystic change

8. Definition
It is spectrum of diseases that are histologically variation of normal breast anatomy with no evidence of malignancy on histopathological examinations.

9. Benign Breast Disease Congenital anomalies Inflammatory lesion ANDI
It includes:
Congenital anomalies
Inflammatory lesion
ANDI
Non breast diseases

10. Benign Breast Disease: Importance
10 times more frequent than carcinoma in patients presenting to physician.
70% of lumps are benign but 30 % can have malignancy or malignant potential.
Anxiety & stress to patients.
Mostly requires reassurance and some pharmacologic treatments only.

11. Congenital anomalies Polymastia, Polythelia Amastia Poland syndrome
Symmastia.

12. Infectious and Inflammatory Breast Disease
Cellulitis, mastitis
Abscess
Surgical drainage
Chronic subareolar abscess
Complete excision of sinus tract
Recurrence is common
Mondor’s disease
Phlebitis of the thoracoepigastric vein.

13. ANDI

14. Classification : histological
Non Proliferative Lesion
Simple Cyst
Complex cyst

15. Simple Cyst

16. Classification : histological
Proliferative Lesions– Without Atypia
Ductal hyperplasia
Fibroadenoma
Intraductal papilloma
Sclerosing Adenoma
Radial Scars

17. Classification : histological
Proliferative Lesions With Atypia-
Atypical ductal hyperplasia
Atypical lobular hyperplasia

18. Classification: malignant potential
Lesions with Increased Risk of Ca
Ductal hyperplasia
Sclerosing adenosis
Atypical hyperplasia
Radial scars

19. Classification: malignant potential
Lesions with no Increased risk of Ca
Fibrocystic disease
Duct ectasia
Solitary papillomas
Simple fibroadenomas
Mastitis or breast abscess
Galactocele
Fat necrosis
Lipoma

20. Syndromic approach:
Mastalgia
Cyclic
Non Cyclic

22. Syndromic approach: Tumors and Masses Nodularity or glandular Cysts
Galactoceles
Fibroadenoma
Sclerosing Adenosis
Lipoma
Harmatoma
Cystosarcoma Phylloides

23. Syndromic approach:

24. BBD

25. (Triple test)

26. Syndromic approach Nipple discharge Galactorrhea
Abnormal nipple discharge