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1. Pathology of the breast
• normal anatomy
•developmental abnormalities
•inflammations
• fibrocystic changes
• tumors
• benign
• malignant
• pathology of the male breast

2. Normal anatomy
•Epithelium:
•Ducts
•Lobules
•Stroma:
•Interlobular
•Lobular

3. Ectopic breast
• supernumerary breast
along the milk lines
Developmental abnormalities

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

8. Cystosarcoma phyllodes
(phyllodes tumor)
•fleshy tumor, leaf-like pattern and cysts on cut surface
•benign, malignant (low grade, high grade)

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

10. Breast carcinoma -
classification
Ductal carcinoma
• Insitu
• Invasive
Lobular carcinoma
• Insitu
• Invasive

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