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REGUB Path - Benign Breast Disease (iii) Fibrocystic changes (Intro…
REGUB Path - Benign Breast Disease (iii) Fibrocystic changes
Intro
common
present in 50%
clinical symptoms in 10%
accounts for majority of surgical procedures performed on female breasts
usually occurs @ 20-40 y/o
due to oestrogen/progesterone imbalance
atypical hyperplasia of ductal epithelium in 5% - a/w increased carc risk
Presentation
may be asymp
discomfort (cyclical)
nodularity
discrete lump (firm, rubbery) - if cyst may be tense or fluctuant
nipple discharge
Morphological changes
affect glandular + stromal elements of breast
cysts (ductal dilation)
apocrine metaplasia (doesn't increase carc risk)
stromal fiborsis
adenosis (increased no of acini per lobule)
Prolif changes
epitheliosis
epithelial hyperplasia (>2 cell layers)
no atypia usually
if atypia: shares some architectural + cytological features of CIS
sclerosing lesions
extensive fibrosis, sclerosis, adenosis
mat mimic carc on radiology + histology
sclerosing adenosis often part of fibrocystic change, or may form a discrete lesion
radial scar/complex sclerosing lesion
larger (several cm)
may present as palpable mass
may be hard + irregular
may be complex histologically
intraductal papilloma
benign neoplasia growth occurring within lactiferous duct
may represent variant or epithelial hyperplasia (fibrocystic disease)
presents with serous or bloody nipple discharge
can recreate (esp if inadequately excised)
premenopausal women
fibrovasc projections lined by epithelial + myoepithelial cells