Faculty of Allied Medical Faculty of Allied Medical SciencesSciences

Histopathology and CytologyHistopathology and Cytology

((MLHC-201MLHC-201))

BREAST BREAST PATHOLOGYPATHOLOGYSupervisionSupervision ::

Prof. Dr. Noha RagabProf. Dr. Noha Ragab

Intended Learning Intended Learning Outcomes Outcomes

By the end of this lecture the By the end of this lecture the student should know student should know

1-the different proliferative and non-1-the different proliferative and non-proliferative breast lesionproliferative breast lesion

2-The types of different inflammations2-The types of different inflammations

3-The different benign breast tumours3-The different benign breast tumours

NORMAL NORMAL BREASTBREAST

Normal breast tissueNormal breast tissue

Breast lobulesBreast lobules

Main ductMain duct

Fibrocystic diseases Fibrocystic diseases of breastof breast

Fibrocystic changesFibrocystic changes::

Clinical presentation:Clinical presentation: Produce palpable Produce palpable ““lumpslumps”” They may cause nodularityThey may cause nodularity

Fibrocystic diseasesFibrocystic diseases::

They can be subdivided into non-They can be subdivided into non-porliferative and proliferative porliferative and proliferative patterns.patterns.

Non-proliferative fibrocystic Non-proliferative fibrocystic changechange

Cysts and fibrosis:Cysts and fibrosis: Characterized by an increase in fibrous Characterized by an increase in fibrous

stroma associated with dilation of ducts stroma associated with dilation of ducts and formation of cysts of various sizes.and formation of cysts of various sizes.

Fibrocystic changes of breastFibrocystic changes of breast

Proliferative fibrocystic Proliferative fibrocystic changechange

Epithelial hyperplasiaEpithelial hyperplasia:: It is proliferative lesion within the ductules, It is proliferative lesion within the ductules,

the terminal ducts and sometimes the lobules the terminal ducts and sometimes the lobules of the breast.of the breast.

Sclerosing adenosis:Sclerosing adenosis: This variant is less common, but it is This variant is less common, but it is

significant because its clinical features are significant because its clinical features are similar to those of carcinoma.similar to those of carcinoma.

Sclerosing adenosisSclerosing adenosis

Epithelial hyperplasiaEpithelial hyperplasia

FIBROCYSTIC DISEASESFIBROCYSTIC DISEASESOF BREASTOF BREAST

NON-PROLIFERATIVENON-PROLIFERATIVEFIBROCYSTIC DISEASEFIBROCYSTIC DISEASE

PROLIFERATIVEPROLIFERATIVEFIBROCYSTIC DISEASEFIBROCYSTIC DISEASE

1.1. EPITHELIAL DUCT HYPERPLASIAEPITHELIAL DUCT HYPERPLASIA2.2. SCLEROSING ADENOSISSCLEROSING ADENOSIS

CYSTS FORMATIONCYSTS FORMATIONANDAND

FIBROSISFIBROSIS

Inflammations of Inflammations of breastbreast

Inflammations of breastInflammations of breast

1.1. Acute mastitisAcute mastitis

2.2. Fat necrosisFat necrosis

3.3. Mammary duct ectasiaMammary duct ectasia

Fat necrosisFat necrosis::

Often related to traumaOften related to trauma Produce a palpable massProduce a palpable mass

Acute mastitis: Acute mastitis: Common during lactationCommon during lactation They usually cause pain and tenderness They usually cause pain and tenderness

in the involved areas.in the involved areas. They are not associated with increased They are not associated with increased

risk of cancer.risk of cancer.

Mammary duct ectasiaMammary duct ectasia:: Granulomatous reaction; this generally Granulomatous reaction; this generally

follows acute mastitis and is a localized follows acute mastitis and is a localized granulomatous reaction. In some granulomatous reaction. In some instances associated with ectasia of the instances associated with ectasia of the ducts (cystic dilatation)ducts (cystic dilatation)

Encountered in women in their 40s and Encountered in women in their 40s and 50s.50s.

Mammary duct ectasia leads to hardness Mammary duct ectasia leads to hardness of the breast substance mimicking the of the breast substance mimicking the changes caused by carcinoma.changes caused by carcinoma.

Tumors of the Tumors of the breastbreast

Benign tumors of Benign tumors of breastbreast

Benign tumors of breastBenign tumors of breast

Fibro adenomaFibro adenoma Phylloids tumourPhylloids tumour Intra ductal papillomaIntra ductal papilloma

FibroadenomaFibroadenoma Most common benign neoplasms of the Most common benign neoplasms of the

female breast. female breast. Almost never become malignant. Almost never become malignant. Peak incidence is in the third decade of Peak incidence is in the third decade of

life.life. Presents as a solitary, discrete, movable Presents as a solitary, discrete, movable

mass.mass.

MicroscopicallyMicroscopically::

FibroadenomaFibroadenoma

Phylloids tumourPhylloids tumour

Much less common than Much less common than fibroadenomas.fibroadenomas.

Arise from the periductal stroma and Arise from the periductal stroma and from preexisting fibroadenomas.from preexisting fibroadenomas.

On gross section they exhibit leaf-like On gross section they exhibit leaf-like clefts and slits, that is why they called clefts and slits, that is why they called phylloids tumors.phylloids tumors.

Microscopically: increased cellularity Microscopically: increased cellularity and stromal overgrowth and stromal overgrowth

Phyllodes tumorPhyllodes tumor

Intra-ductal papillomaIntra-ductal papilloma

A benign neoplastic papillary growth A benign neoplastic papillary growth within a duct.within a duct.

Solitary and found within the Solitary and found within the principal lactiferous ducts or sinuses.principal lactiferous ducts or sinuses.

Microscopically: benign papillary Microscopically: benign papillary growth within a main lactiferous ductgrowth within a main lactiferous duct

Clinically:Clinically: Appearance of serous or bloody nipple Appearance of serous or bloody nipple

dischargedischarge Presence of small sub-areolar tumourPresence of small sub-areolar tumour

Intra-ductal papillomaIntra-ductal papilloma

Intra-ductal papillomaIntra-ductal papilloma

QuestionsQuestionsCompleteComplete: :

11 - -Fibrocystic diseases can be subdivided intoFibrocystic diseases can be subdivided into ………………

22 - -The inflammations of the breast includeThe inflammations of the breast include……… ………

33 - -The benign tumors of the breast includeThe benign tumors of the breast include……… ………

44 - -The most common benign neoplasms of the The most common benign neoplasms of the female breast arefemale breast are..……… ..………

55 - -Principal lactiferous ducts or sinuses exhibit Principal lactiferous ducts or sinuses exhibit the growth ofthe growth of.…… .……

AssignmentsAssignments

Rheumatic feverRheumatic fever

محمد رأفت محمد أمل رأفت أمل

نعينع أحمد بدوي نعينع امنية أحمد بدوي امنية

الجمل محمد صبري الجمل امنية محمد صبري امنية

HypertensionHypertension

الوهاب عبد الحي عبد الوهاب امنية عبد الحي عبد امنيةعلي علي محمد محمد

علي حسن رفعت علي أميرة حسن رفعت أميرةأحمدأحمد

الشحات صالح الشحات أميرة صالح أميرةحسين حسين ابراهيم ابراهيم

Thank YouThank You