Benign Benign Fibroadenoma breast epithelial lesions are grouped histologically as nonproliferative, proliferative without atypia Atypia Fibrocystic Change, and atypical hyperplasia Hyperplasia An increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. Cellular Adaptation. The classifications are based on subsequent cancer risk in either breast. The nonproliferative type carries no risk, while fibroadenoma Fibroadenoma Fibroadenomas are the most common benign tumor of the female breast and the most common breast tumor in adolescent and young women. The tumors are well-circumscribed, mobile, and unencapsulated, with a rubbery or firm consistency. Fibroadenoma, the most common benign tumor Tumor Inflammation, is a proliferative breast lesion (i.e., has a slight increase in malignancy Malignancy Hemothorax risk). Because atypical hyperplasia Hyperplasia An increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. Cellular Adaptation shares some features with breast carcinoma in situ Carcinoma in situ A lesion with cytological characteristics associated with invasive carcinoma but the tumor cells are confined to the epithelium of origin, without invasion of the basement membrane. Leukoplakia, future cancer potential is increased. Management ranges from frequent monitoring to surgical excision, depending on certain factors, including the inherent risk of the pathologic diagnosis. Other breast disorders without malignant possibility are associated with underlying infection or systemic disease, so treatment differs. Benign Benign Fibroadenoma breast diseases are common but present diversely. It is important to distinguish between them to determine the likelihood of cancer and the best course of treatment.
Last updated: 25 Feb, 2021
Nonproliferative breast lesions are conditions generally not associated with an increased risk of breast cancer Breast cancer Breast cancer is a disease characterized by malignant transformation of the epithelial cells of the breast. Breast cancer is the most common form of cancer and 2nd most common cause of cancer-related death among women. Breast Cancer.
Breast US shows a simple cyst (A) presenting as an anechoic Anechoic A structure that produces no echo at all (looks completely black) Ultrasound (Sonography) lesion with posterior enhancement and a cyst (B) with a septum (arrow). Breast US (C) in a 26-year-old woman with a painless palpable lump in her left breast shows a complex cyst Complex Cyst Imaging of the Breast with an eccentrically placed echogenic focus Focus Area of enhancement measuring < 5 mm in diameter Imaging of the Breast (arrow) representing the scolex Scolex Taenia/Taeniasis of a cysticercus granuloma. The patient also had a similar swelling Swelling Inflammation in the right upper arm Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy, a US (D) of which revealed a cyst (arrow) with an echogenic scolex Scolex Taenia/Taeniasis (arrowhead), within.
Image: “Breast USG” by Advanced Radiology Centre, Mumbai, India. License: CC BY 2.0In proliferative breast lesions without atypia Atypia Fibrocystic Change, the development of breast cancer Breast cancer Breast cancer is a disease characterized by malignant transformation of the epithelial cells of the breast. Breast cancer is the most common form of cancer and 2nd most common cause of cancer-related death among women. Breast Cancer is 1.5–2 times the risk of the general population.
A: Multiple intraductal papillomas within the same dilated duct.
B: A papilloma arising from the wall of the duct, nearly filling the lumen of the duct. A vascular stalk is seen.
Craniocaudal (a) and mediolateral oblique (b) mammographic images show the filling stops a few millimeters from the nipple of the cannulated duct; imaging finding is suggestive of papilloma.
Magnetic resonance imaging (MRI) (T1-weighted 3D flash acquired in the axial plane) shows a mass intraductal enhancement in the retroareolar area (c) with round and sharp margins, indicative of a benign proliferation of the ductal epithelium (papilloma). Histology later confirmed the papilloma diagnosis.
Image: “Galactography” by Department of Radiological Sciences, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy. License: CC BY 3.0Histological appearance of Intraductal papilloma (IDP) of the left breast in low-power field, ×40 (A). Two-cell pattern lined by luminal cuboidal cells and a distinct outer layer of myoepithelial cells under higher magnification, ×200 (B). Image: “Histological appearance of IDP” by Institute for Oncology and Radiology of Serbia, 14 Pasterova, Belgrade 11000, Serbia. License: CC BY 2.0
Intraductal papillomas
Image: “Immunohistochemical staining for TFPI TFPI Hemostasis-2 expression in breast tumors” by Department of Breast Surgery, Yangpu Hospital, Tongji University, Shanghai 200090, China. License: CC BY 2.0Microscopic examination of intraductal
fibroadenoma
Fibroadenoma
Fibroadenomas are the most common benign tumor of the female breast and the most common breast tumor in adolescent and young women. The tumors are well-circumscribed, mobile, and unencapsulated, with a rubbery or firm consistency.
Fibroadenoma or intraductal phyllodes tumour of the breast
(A) Low
power
Power
The probability that a test will correctly reject a false null hypothesis.
Statistical Tests and Data Representation view showed that its polypoid parts were composed of leaf-like processes with a hypocellular and prominent myxoid stroma, protruding into
cystic
Cystic
Fibrocystic Change spaces, reminiscent of intracanalicular type
fibroadenoma
Fibroadenoma
Fibroadenomas are the most common benign tumor of the female breast and the most common breast tumor in adolescent and young women. The tumors are well-circumscribed, mobile, and unencapsulated, with a rubbery or firm consistency.
Fibroadenoma or benign phyllodes tumour features (H&E stains). Bar = 200 μm.
(B) In some areas, there were foci of typical intracanalicular variant of
fibroadenoma
Fibroadenoma
Fibroadenomas are the most common benign tumor of the female breast and the most common breast tumor in adolescent and young women. The tumors are well-circumscribed, mobile, and unencapsulated, with a rubbery or firm consistency.
Fibroadenoma, in which duct lumens were compressed by the proliferating myxoid stroma (H&E stains). Bar = 200 μm.
(C) On high-
power
Power
The probability that a test will correctly reject a false null hypothesis.
Statistical Tests and Data Representation view, those stromal cells showed no significant
atypia
Atypia
Fibrocystic Change, but the covering
hyperplastic
Hyperplastic
Colon Polyps epithelial components were also bland-looking in 2 cell layers. Mitotic figures were very rarely seen (H&E stains). Bar = 200 μm.
(D) In others, tiny foci of benign intraductal
papilloma
Papilloma
A circumscribed benign epithelial tumor projecting from the surrounding surface; more precisely, a benign epithelial neoplasm consisting of villous or arborescent outgrowths of fibrovascular stroma covered by neoplastic cells.
Cowden Syndrome with characteristic delicate fibrovascular stalks were rarely seen (H&E stains). Bar = 100 μm.
A: Breast ultrasonography in a 25-year-old patient shows a homogenous,
hypoechoic
Hypoechoic
A structure that produces a low-amplitude echo (darker grays)
Ultrasound (Sonography), gently lobulated lesion (arrow), suggestive of a
fibroadenoma
Fibroadenoma
Fibroadenomas are the most common benign tumor of the female breast and the most common breast tumor in adolescent and young women. The tumors are well-circumscribed, mobile, and unencapsulated, with a rubbery or firm consistency.
Fibroadenoma.
B: Ultrasonography shows a degenerating
fibroadenoma
Fibroadenoma
Fibroadenomas are the most common benign tumor of the female breast and the most common breast tumor in adolescent and young women. The tumors are well-circumscribed, mobile, and unencapsulated, with a rubbery or firm consistency.
Fibroadenoma (arrow) with coarse calcifications (arrowhead) and posterior shadowing from the calcific foci.
Fibroadenoma on a mammogram
Image: “Fibroadenoma on mammogram” by S. Bhimji MD. License: CC BY 4.0Usual ductal hyperplasia Hyperplasia An increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. Cellular Adaptation after review. Note the epithelial cells displaying a haphazard orientation Orientation Awareness of oneself in relation to time, place and person. Psychiatric Assessment and the presence of slit-like secondary lumina peripherally located.
Image: “Usual ductal hyperplasia Hyperplasia An increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. Cellular Adaptation” by Breast Pathology Laboratory, School of Medicine, Federal University of Minas Gerais (UFMG), Av, Professor Alfredo Balena, 190, Belo Horizonte, Minas Gerais 30130-100, Brazil. License: CC BY 2.0Atypical ductal hyperplasia Hyperplasia An increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. Cellular Adaptation (arrows)
Image: “Atypical ductal hyperplasia Hyperplasia An increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. Cellular Adaptation” by Breast Pathology Laboratory, School of Medicine, Federal University of Minas Gerais (UFMG), Av, Professor Alfredo Balena, 190, Belo Horizonte, Minas Gerais 30130-100, Brazil. License: CC BY 2.0Photomicrograph of atypical lobular hyperplasia Hyperplasia An increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. Cellular Adaptation associated with columnar cell changes and incidental to targeted microcalcifications
Image: “Atypical lobular hyperplasia Hyperplasia An increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. Cellular Adaptation” by Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas. License: CC BY 3.0Columnar cell lesions with atypia Atypia Fibrocystic Change (flat epithelial atypia Atypia Fibrocystic Change)
Image: “Flat epithelial atypia Atypia Fibrocystic Change” by Department of Pathology, Wilford Hall Medical Center, Lackland AFB AFB Mycobacterium, TX, USA. License: CC BY 2.0Sonogram Sonogram Chorioretinitis of a 22-year-old woman showing a right breast abscess Abscess Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. Chronic Granulomatous Disease. Note the oval shape of the abscess Abscess Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. Chronic Granulomatous Disease, which measures 2.64 cm by 1.54 cm before aspiration under ultrasound guidance.
Image: “Breast abscess Abscess Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. Chronic Granulomatous Disease” by Department of Surgery, Weil Bugando University College of Health Sciences, Mwanza, Tanzania. License: CC BY 2.0Galactocele:
A: Lesion parallel to the
skin
Skin
The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue.
Skin: Structure and Functions with well-defined borders showing
anechoic
Anechoic
A structure that produces no echo at all (looks completely black)
Ultrasound (Sonography) (
cystic
Cystic
Fibrocystic Change) and echogenic (solid) components, with discrete posterior acoustic enhancement and well-defined borders.
B: Predominantly
hypoechoic
Hypoechoic
A structure that produces a low-amplitude echo (darker grays)
Ultrasound (Sonography) lesion parallel to the
skin
Skin
The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue.
Skin: Structure and Functions with well-defined borders, peripheral areas of hyperechogenicity, and posterior acoustic enhancement.
Phyllodes
tumor
Tumor
Inflammation of the breast
(a) Transverse US image shows a circumscribed heterogenous echo with a small
cystic
Cystic
Fibrocystic Change space (arrow) and a slight posterior acoustic enhancement.
(b) Photomicrograph shows leaf-like processes containing cellular stroma lined with benign ductal epithelial cells projecting into the
cystic
Cystic
Fibrocystic Change space (haematoxylin & eosin stain; x100).