Diseases of Breast

Pathology-B LabRavi A Patel

M++Paget disease

Fibrocystic change

Infiltrating/Invasive ductal carcinoma

Fibroadenoma

Lipoma

There are 2 types of Breast diseases

1) Invasive(Infiltrating)a. Invasive ductal carcinomab. Medullary carcinomac. Colloid carcinomad. Tubular carcinomae. Other types

2) Non invasivea. Ductal carcinoma in situ(DCIS – intraductal carcinoma)-

includes Paget diseaseb. Lobular carcinoma in situ(LCIS)

Paget disease

• Characterized by extension of of Ductal carcinoma in situ (DCIS) up to the lactiferous ducts and into the skin of Nipple.

• Clinical appearance- Unilateral crusting exudate over the nipple and areolar skin.

• Its a benign breast lesion

Skin of Areola

PAGET CELLS WITHCLEAR CYTOPLASM AND HYPERCHROMATICPLEOMORPHIC NUCLEI WHICH ARE INFILTRATING THE DERMIS

Atypical liningcells

Paget cells and Atypical ductal lining cells

Fibrocystic Change

• The term change is applied to miscellany changes in the female breast that range from harmless to patterns associated with Breast Carcinoma.

• Some of these alteration- Stromal fibrosis and micro/macro cyst produce palpable lumps.

• These changes are the consequence of an exaggeration and distortion of the cystic breast changes that occur normally in menstrual cycle.

There are 2 types

• Proliferative- Includes atypical duct or ductal epithelial cell hyperplasias.

• Non proliferative- includes cyst and fibrosis without epithelia hyperplasia..Also known as Simple fibrocystic change.It is very common(found in 60-80% of women)

• All these changes tend to rise during the reproductive period of life but may persist after menopause.

* Dilated duct with visible lining epithelial cells-LPO

NumerousMicrocysts Produced by The dilated ducts

Observation

--- Increased Fibrosis in stroma--- Dilated ducts within fibrosis--- There is no Epithelial hyperplasia of the ductal lining cells. If there is hyperplasia then the whole lumen gets filled with heterogenous cells.

---- So we can conclude that that the slide shown falls under the most commonly found Fibrocystic change that is Non proliferative type..

HPO

Non-ProliferativeType of Fibrocystic Change

--Fibrosis seen but No Hyperplasia

HPO

Fibrosis

Dilated ducts

HPO

HPO

Infiltrating/Invasive Ductal Carcinoma

• Due to abnormally proliferating ductal lining cells, there is invasion of stroma

• In normal breast tissue– Ducts= Stroma

– Whereas in Infiltrating ductal carcinoma there is very little stroma

Normal Breast tissue is not found

Malignant Ductal lining cellsObserved to be arranged in sheetsPleomorphism

And Hyperchromatic nuclei Of the ductal lining cells

HPO

Fibroadenoma

• Proliferating intralobular stroma pushing the epithelium

• There are 2 types of fibroadenoma1. Pericanalicular Fibroadenoma

In this kind of Fibroadenoma the ductal space are round/oval and fairly regualar

2. Intracanalicular Fibroadenoma Over here there is extensive proliferation of

surrounding stroma which compresses the ducts giving them irregular/star shape on cross section.

Poliferating Stroma is pushing The ducts leading to their irregularShape..This signifies of the slide being Intracanalicular fibradenoma

Fibroadenoma

Intracanalicular type Pericanalicular type

Lipoma

• Lipomas are benign tumours of fat and are most common soft tissue tumour of adulthood.

• Most are solitary lesions.

• Most Lipomas are mobile,slowly enlarging painless masses(angiolipoma can present with local pain)

• Complete excision is usually curative..

Subtypes of Lipoma• Conventional- Most common subtype- they are soft, yellow, well

encapsulated masses of mature adipocyytes with considerable varying size.

• Myolipoma

• Spindle cell

• Myelolipoma

• Pleomorphic

• Angiolipoma(locally painful)

Lipoma

LPO

Mature Fat cells withScanty stroma

RemnantsOf mammaryGlandlobules

Fat cells areWithin a thin fibrous capsule

LPO

HPO

Fibrous capsule

HPO

Scanty stroma and Fat cells

Thanking to the entire Universe