Difference between revisions of "Fibrocystic breast changes"

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|author1=[[User:Mikael Häggström|Mikael Häggström]]
 
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==Presentations==
 
==Presentations==
 
*[[Breast biopsy or excision]]
 
*[[Breast biopsy or excision]]
 
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==Microscopic examination==
 
==Microscopic examination==
 
Types:
 
Types:
<gallery mode=packed>
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File:Histopathology of sclerosing adenosis of the breast.jpg|'''Sclerosing adenosis''', with an increase in glandular elements in addition to stromal proliferation that distorts and compresses glands.<ref name=PathologyOutlines>{{cite web|url=https://www.pathologyoutlines.com/topic/breastsclerosingadenosis.html|title=Breast - Fibrocystic changes - Sclerosing adenosis|author=Jaya Ruth Asirvatham, M.B.B.S., Julie M. Jorns, M.D.|website=Pathology Outlines}} Topic Completed: 1 January 2015. Minor changes: 31 December 2020</ref>
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File:Histopathology of sclerosing adenosis of the breast.jpg|'''Sclerosing adenosis''', with an increase in glandular elements in addition to stromal proliferation that distorts and compresses glands.<ref name=PathologyOutlines-fibrocystic>{{cite web|url=https://www.pathologyoutlines.com/topic/breastsclerosingadenosis.html|title=Breast - Fibrocystic changes - Sclerosing adenosis|author=Jaya Ruth Asirvatham, M.B.B.S., Julie M. Jorns, M.D.|website=Pathology Outlines}} Topic Completed: 1 January 2015. Minor changes: 31 December 2020</ref>
 
File:Histopathology of a radial scar of the breast.jpg|A '''radial scar''' of the breast, seen as a fibroelastic stroma and entrapped glands radiating outward.
 
File:Histopathology of a radial scar of the breast.jpg|A '''radial scar''' of the breast, seen as a fibroelastic stroma and entrapped glands radiating outward.
 
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===Differential diagnosis===
 
===Differential diagnosis===
Sclerosing adenosis may look similar to [[invasive ductal carcinoma]] (IDC), but IDC will:<ref name=PathologyOutlines/>
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Sclerosing adenosis may look similar to [[invasive ductal carcinoma]] (IDC), but IDC will:<ref name=PathologyOutlines-fibrocystic/>
 
*Not be lobular at low power
 
*Not be lobular at low power
 
*Have marked cellular atypia
 
*Have marked cellular atypia
*Have no myoepithelial cells surrounding duccts.
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*Have no myoepithelial cells surrounding ducts.
 
 
When unsure, perform immunohistochemistry for '''calponin''':
 
[[File:Chromogenic immunohistochemistry for calponin in sclerosing adenosis.jpg|thumb|center|Immunostain for caplonin in sclerosing adenosis, showing myoepithelial cells surrounding the ducts, thereby excluding invasive carcinoma.]]
 
  
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When unsure, perform immunohistochemistry for myoepithelial markers (preferably '''p63''' and '''calponin''' in breast lesions):
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[[File:Chromogenic immunohistochemistry for calponin in sclerosing adenosis.jpg|thumb|center|Immunostain with a myoepithelial marker (calponin) in sclerosing adenosis, showing myoepithelial cells surrounding the ducts, thereby excluding invasive carcinoma.]]
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Revision as of 10:50, 4 December 2022

Author: Mikael Häggström [note 1]

Presentations

Microscopic examination

Types:

Differential diagnosis

Sclerosing adenosis may look similar to invasive ductal carcinoma (IDC), but IDC will:[1]

  • Not be lobular at low power
  • Have marked cellular atypia
  • Have no myoepithelial cells surrounding ducts.

When unsure, perform immunohistochemistry for myoepithelial markers (preferably p63 and calponin in breast lesions):

Immunostain with a myoepithelial marker (calponin) in sclerosing adenosis, showing myoepithelial cells surrounding the ducts, thereby excluding invasive carcinoma.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. 1.0 1.1 Jaya Ruth Asirvatham, M.B.B.S., Julie M. Jorns, M.D.. Breast - Fibrocystic changes - Sclerosing adenosis. Pathology Outlines. Topic Completed: 1 January 2015. Minor changes: 31 December 2020

Image sources