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A high yield review of

Tiffany M. Graham, M.D.

(4th year Pathology Resident)

Breast

Pathology

Table of Contents.

Breast Basics.

Benign Breast Disease.

Pre-Cancerous Lesions.

Breast Cancer.

Cancer Grading & Staging.

Tips for Breast Sign-Out.

Grossing Manual.

SEE ALL TOPICS

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Recent Posts.

Recent Posts

Breast (Cytology) Mindmap

Click on Attachment or Image below to download the original PDF document

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Breast Pathology Mindmap Cytology

Interactive Breast Mindmap

Click on the image below to open this INTERACTIVE BREAST PATHOLOGY MINDMAP

 for a rapid review of the pure "need to know" topics in breast pathology.

 

To expand a topic, double click on the underlined topic. Close the "branch" by double clicking again.

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Click on the Image to open this interactive mindmap in a new window

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The Basics of Breast Pathology

Breast Basics.

Breast

Anatomy

& Histology

In order to learn about the disease, one must fully understand the basic anatomy and histology of the breast. Here is a quick recap of benign breast tissue.

Click to learn more...

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Breast development occurs under the control of many hormones such as  prolactin, growth hormones, estrogen, progesterone, and adrenocorticoids. Hormonal fluctuation is greatest during puberty, pregnancy and menopause; these changes can be appreciated histologically.

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Breast imaging studies are performed in the workup of breast cancer. Pathologists are expected to correlate the histologic findings with imaging to make an accurate diagnosis. Click to learn more...

Benign Breast Diseases

Benign Breast Disease.

Benign diseases of the breast can be categorized as non-proliferative, proliferative and proliferative lesions with atypia. Proliferative lesions have an increased risk for breast cancer development. This post contains a quick overview of benign breast lesions before we delve further into the specifics of each disease. Click to learn more

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Benign: Inflammatory Conditions
Inflammatory breast disease
Benign: Non-Proliferative Lesions

“Fibrocystic disease” also referred to as "fibrocystic changes (FCC)" is the wastebasket term for benign breast disease characterized by fibrosis, cysts, inflammation, and a host of other benign changes. This post contains all the highlights of the various histologic patterns that encompass fibrocystic breast disease.

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Non Proliferative fibrocystic changes:

  • Cyst formation/ Duct ectasia

  • Stromal fibrosis

  • Apocrine metaplasia

  • Adenosis

  • Calcifications

Proliferative fibrocystic changes:​

  • Sclerosing Adenosis

  • Columnar Cell Change (CCC)

  • Flat epithelial atypia (FEA)

  • *Usual ductal hyperplasia (UDH)

  • *Papillomas

  • *Radial scar/radial sclerosing lesion

* = Topics covered in separate posts​

Learn more about Fibrocystic Breast Disease

Benign: Non Proliferative Disease

Gynecomastia

Refers to an increased amount of breast tissue in a male. Often due to excess estrogen. Can be idiopathic or associated with BRCA2 mutation. Histology shows enlarged ducts with increased stroma (NO lobules). 

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Benign: Proliferative Breast Lesions
Fibroadenoma
Benign: Proliferative Disease
Intraductal Papilloma
Papillomatosis
Phyllodes Tumor
Sclerosing Adenosis
UDH-ADH-DCIS-Cancer progression
Typical Breast Cancer Progression

Ductal Proliferative Pathway

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Invasive Ductal Carcinoma (IDC)

Lobular Proliferative Pathway