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Breast Carcinoma
1. Pathology of the breast
• normal anatomy
•developmental abnormalities
•inflammations
• fibrocystic changes
• tumors
• benign
• malignant
• pathology of the male breast
4. Inflammatory and reactive
conditions
Fat necrosis
• can form mass clinically
• history of trauma or prior surgical intervention)
• histiocytes with foamy cytoplasm
5. Inflammatory and reactive
conditions
Granulomatous Lobular Mastitis
• etiology unknown
Mammary duct ectasia
• periductal inflammation, duct sclerosis
• intermittent nipple discharge
Tuberculosis
•lactating breast, innoculation via the lactiferous ducts
• slowly growing, solitary, painless mass
6. Benign proliferative lesions
Fibrocystic changes:
• Fibrosis, cysts, Apocrine change and papillae
Hyperplasia:
• ductal and lobular hyperplasia
• atypical ductal and lobular hyperplasia
7. Benign tumors
Fibroadenoma
• proliferation of epithelial and stromal elements
• most common breast tumor in adolescent and young
adult women (peak age = third decade)
•well-circumscribed, freely movable, nonpainful mass
• ducts distorted into slit-like structures
Tubular adenoma
Lactating Adenoma
9. Breast carcinoma
• most frequent malignant tumor in
females
•risk factors: genetic predisposition
(breast ca in close/ 1st
degree relatives),
history of ca (breast, ovary,
endometrium)
• importance of preventive controls! –
early diagnosis better prognosis
11. Carcinoma in situ
• preinvasive - does not form a palpable tumor
• not detected clinically (only X-ray – screening !!!)
•no metastatic spread (basement membrane)
• risk of invasion depending on grade
12. Invasive carcinoma
Invasive ductal carcinoma
• largest group (65 to 80 % of mammary carcinomas)
• mid to late fifties
Invasive lobular carcinoma
• uniform cells, infiltrative growth (linear arrangement -
indian file pattern)
13. • other types: tubular, mucinous, medullary,
inflammatory – together about 10 % of breast ca
• metastases: regional lymph nodes
• treatment: surgery
radiotherapy
antihormonal therapy (Tamoxifen)
chemotherapy
Invasive carcinoma
14. Pathology of the male breast
Gynecomastia
• most common clinical and pathologic abnormality of the
male breast
• increase in subareolar tissue
• associated with decreased androgens or increased
estrogen: cirrhosis of the liver, chronic renal failure and hypogonadism
Carcinoma of the male breast
• uncommon < 1 % of all breast cancers