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Type
Characteristics
INTRADUCTAL PAPILLOMA
(DUCT PAPILLOMA)
benign
Neoplastic papillary (epithelial) growth develops
within a principle lactiferous duct near the
nipple
To a women at / shortly before menopause
May / may not form a palpable mass:
Clinical pictures
Morphology :
GROSSLY
MICROSCOPIC
Large papillomas :
Solitary
Delicate branching growth within a dilated duct
attached to wall of duct by fibrovascular stalk
Small duct papillomas :
Multiple
Deeply found within the duct
Composed of multiple papillae each lined by CT
cuboidal and myoepithelial cells
Solitary papillomas benign
Small multiple papillomas high risk of
malignancy duct carcinoma ; severe cytologic
atypia and abnormal mitotic figures
FIBROADENOMA
(breast mouse)
Benign
Most common benign tumor of female breast
Appears to women frequently before 35 years
old
Arises from terminal duct lobular unit
The stromal cell represent the neoplastic
element of the tumor.
Stromal cell may secrete chemical secretion
substance that cause proliferation of terminal
ducts and acini
An absolute / relative increase in estrogen
activities
Usually solitary, discrete movable painless mass
Slightly increase in size during late phase of
each menstrual cycle
Regression tumor usually occurs after
menopause
Complete surgical excision is curative
Usually spherical solitary and occasionally
multiple
Encapsulated and easily shelled out
Size varies 1-10cm in diameter
Firm in consistency
CS is grey-white (increase fibro CT)
Prolifreration of terminal ducts, acini and
stroma
Pericanalicular fibroadenoma : ductal and
glandular like spaces are open, round to oval
and regular
Intracanalicular fibroadenoma : ductal and
glandular like space are compressed by
extensive proliferation of the stroma in CS ;
slits / irregular star shape structures
Both are coexist with predominant on the other
and have no clinical significant
PHYLLODES TUMOR
(CYSTOSARCOMA PHYLLODES)
Benign / malignant
Occurs less commonly than
fibroadenoma
Arise from intralobular stroma (not
from preexisting fibroadenoma)
Occurs 10-20 years later than
fibroadenoma
Usually occur to premenopausal
women
Usually may be mistaken diagnose as
fibroadenoma
Painless mass
Stromal hypercellularity
Few glandular elements
Benign : stromal cell shows no
cytologic evidence of malignancy
Malignant :
shows anaplastic and high mitotic
activity
tends to recur after excision
metastasize to distant sites
demonstrating only stromal
component
PRIMARY
METASTATIC / 2NDRY
SARCOMA
(RARE)
Very rare
Maybe :
Sarcoma
Liposarcoma
Undifferentiated sarcoma
carcinoma of the
other breast
malignant melanoma
lung cancer
CARCINOMA
Ductal Carcinoma
Lobular Carcinoma
CARCINOMA IN SITU (LCIS)
Characteristic
Grossly
Microscopic
5% of breast carcinoma
Especially noticed in post menopausal women
High incidence of bilateralism (20%)
mandates a careful clinical & histological
evaluation of the other breast
Poorly circumscribed
Rubbery in consistency