Breast Pathology, UTSHC Fall 2022 D2
Pathology
What are the Distinguishing Features of the Breast From Other organs?
- Nutritional support of another individual, as the major function
- Marked changes of the structure throughout life
- Having a social, cultural, and personal significance
Normal Breast Structure and Histology
- Two major structures: ducts and lobules
- Lobule as the functional unit of the breast
- Two types of epithelial cells (luminal and myoepithelial)
- Two types of stroma (intralobular and interlobular)
- Six to 10 major ducts orifices open onto the skin surface at the nipple
what are the two major structures of the breast?
ducts and lobules
what is the functional unit of the breast?
lobule
what are the two types of epithelial cells that make up breasts?
luminal and interlobular
about how many major ducts orifices open onto the skin surface at the nipple?
6-10
What are some cells you will see in the Normal Breast Structure and Histology?
- Intralobular stroma
- Ducts
- Lobules
- Adipose tissue
Life Cycle changes in breast tissue: after menarche
Expansion of the lobular system and periodic remodeling during adulthood
Life Cycle changes in breast tissue: onset of pregnancy
Complete maturation and functional of the breasts with increase in number and the size
of the lobules: permanent changes
Life Cycle changes in breast tissue: after the third decade until menopause
Involution and regression of the lobules and their specialized stroma and conversion of
the interlobular stroma to adipose tissue
Clinical Presentation of Breast Disease
- Inflammation
- Palpable mass
- Lumpiness or other symptoms
- Pain
- Nipple discharge
are the clinical presentation of breast disease good indicators of breast cancer?
No, at most 7% turn out to be cancer
what is the best way to check for breast cancer?
mammogram screening, followed by palpable mass
, Clinical Presentation of the Breast Disease: Pain (mastalgia or mastodynia)
- A common symptom. Maybe cyclic or noncyclic
- Diffuse cyclic due to premenstrual edema
- Localized noncyclic may be caused by ruptured cysts, physical injury, and infections
- Almost all painful masses are benign
- 10% of breast cancers presents with pain
Clinical Presentation of the Breast Disease: Inflammation
- Causes edematous and erythematous breast, mostly by infections, during lactation
and breastfeeding
- Different from "inflammatory" breast carcinoma
Clinical Presentation of the Breast Disease: Nipple discharge
- May be normal when small in quantity and bilateral
- Papilloma arising in the large ducts below the nipple as the most common benign
lesion producing a nipple discharge
- Galactorrhea, not associated with malignancy
- Increase in risk of malignancy in a woman with nipple discharge with age (carcinoma
in 7% of women younger than 60 but in 30% of older women)
Clinical Presentation of the Breast Disease: Lumpiness
- A diffuse nodularity throughout the breast, a result of normal glandular tissue
- If pronounced, imaging studies may be helpful
Clinical Presentation of the Breast Disease: Palpable masses
- Due to epithelial or stroma proliferation
- Generally detected when are 2-3 cm in size
- Round/oval circumscribed; 95 % are benign
- Masses with irregular border as malignant
- All palpable masses require evaluation
Clinical Presentation of the Breast Disease: Gynecomastia
The only common breast symptom in males, resulting from imbalance between
estrogens and androgens
Mammographic Screening
Introduced in the 1980s as a means to detect small, nonpalpable, asymptomatic breast
carcinomas
what is the most common means to detect breast cancer?
Mammographic Screening
How do the sensitivity and specificity of mammography change with age? Why?
increase with age, due to the changes in the breast tissue
what are the probabilities of a mammographic lesion to be cancer at age 40 and
over 50?
10% at 40, 25% over 50
what are the principle mammographic signs of breast carcinomas?
densities and calcifications
Ultrasonography in breast imaging
distinguishes between solid and cystic lesions and defines more precisely the borders of
solid lesions
Magnetic resonance imaging (MRI) in breast imaging
Pathology
What are the Distinguishing Features of the Breast From Other organs?
- Nutritional support of another individual, as the major function
- Marked changes of the structure throughout life
- Having a social, cultural, and personal significance
Normal Breast Structure and Histology
- Two major structures: ducts and lobules
- Lobule as the functional unit of the breast
- Two types of epithelial cells (luminal and myoepithelial)
- Two types of stroma (intralobular and interlobular)
- Six to 10 major ducts orifices open onto the skin surface at the nipple
what are the two major structures of the breast?
ducts and lobules
what is the functional unit of the breast?
lobule
what are the two types of epithelial cells that make up breasts?
luminal and interlobular
about how many major ducts orifices open onto the skin surface at the nipple?
6-10
What are some cells you will see in the Normal Breast Structure and Histology?
- Intralobular stroma
- Ducts
- Lobules
- Adipose tissue
Life Cycle changes in breast tissue: after menarche
Expansion of the lobular system and periodic remodeling during adulthood
Life Cycle changes in breast tissue: onset of pregnancy
Complete maturation and functional of the breasts with increase in number and the size
of the lobules: permanent changes
Life Cycle changes in breast tissue: after the third decade until menopause
Involution and regression of the lobules and their specialized stroma and conversion of
the interlobular stroma to adipose tissue
Clinical Presentation of Breast Disease
- Inflammation
- Palpable mass
- Lumpiness or other symptoms
- Pain
- Nipple discharge
are the clinical presentation of breast disease good indicators of breast cancer?
No, at most 7% turn out to be cancer
what is the best way to check for breast cancer?
mammogram screening, followed by palpable mass
, Clinical Presentation of the Breast Disease: Pain (mastalgia or mastodynia)
- A common symptom. Maybe cyclic or noncyclic
- Diffuse cyclic due to premenstrual edema
- Localized noncyclic may be caused by ruptured cysts, physical injury, and infections
- Almost all painful masses are benign
- 10% of breast cancers presents with pain
Clinical Presentation of the Breast Disease: Inflammation
- Causes edematous and erythematous breast, mostly by infections, during lactation
and breastfeeding
- Different from "inflammatory" breast carcinoma
Clinical Presentation of the Breast Disease: Nipple discharge
- May be normal when small in quantity and bilateral
- Papilloma arising in the large ducts below the nipple as the most common benign
lesion producing a nipple discharge
- Galactorrhea, not associated with malignancy
- Increase in risk of malignancy in a woman with nipple discharge with age (carcinoma
in 7% of women younger than 60 but in 30% of older women)
Clinical Presentation of the Breast Disease: Lumpiness
- A diffuse nodularity throughout the breast, a result of normal glandular tissue
- If pronounced, imaging studies may be helpful
Clinical Presentation of the Breast Disease: Palpable masses
- Due to epithelial or stroma proliferation
- Generally detected when are 2-3 cm in size
- Round/oval circumscribed; 95 % are benign
- Masses with irregular border as malignant
- All palpable masses require evaluation
Clinical Presentation of the Breast Disease: Gynecomastia
The only common breast symptom in males, resulting from imbalance between
estrogens and androgens
Mammographic Screening
Introduced in the 1980s as a means to detect small, nonpalpable, asymptomatic breast
carcinomas
what is the most common means to detect breast cancer?
Mammographic Screening
How do the sensitivity and specificity of mammography change with age? Why?
increase with age, due to the changes in the breast tissue
what are the probabilities of a mammographic lesion to be cancer at age 40 and
over 50?
10% at 40, 25% over 50
what are the principle mammographic signs of breast carcinomas?
densities and calcifications
Ultrasonography in breast imaging
distinguishes between solid and cystic lesions and defines more precisely the borders of
solid lesions
Magnetic resonance imaging (MRI) in breast imaging
