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| [[Image:Diagram showing the lobes and ducts of a breast CRUK 307.svg|thumb|250px|Diagram of the structure of breast. (CRUK/WC)]] | | [[Image:Diagram showing the lobes and ducts of a breast CRUK 307.svg|thumb|250px|Diagram of the structure of breast. (CRUK/WC)]] |
| The '''breast''' is an important organ for the continuance of the species and one that [[pathologist]]s see quite often because it is often afflicted by [[breast cancer|cancer]]. Before women started [[smoking]] in large numbers, it was the number one cause of cancer death in women (in Canada). | | The '''breast''' is an important organ that [[pathologist]]s see quite often because it is often afflicted by [[breast cancer|cancer]]. Before women started [[smoking]] in large numbers, it was a leading cause of cancer death in women. |
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| Fortunately, breast cancer, these days, has a relatively good prognosis if it is detected early... and this is why there are week-ends to end breast cancer -- there are large numbers of breast cancer survivors that are well, wealthy and can advocate for better care and research into breast cancer. | | Fortunately, breast cancer, in this day, has a relatively good prognosis if it is detected early. |
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| =Clinical= | | =Clinical= |
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| ==Columnar cell change== | | ==Columnar cell change== |
| *Abbreviated ''[[CCC]]''.
| | {{Main|Columnar cell change of the breast}} |
| *[[AKA]] ''blunt duct adenosis''.
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| ===General===
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| *Columnar cell change is associated with (benign) calcification - '''key point'''.
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| ===Microscopic===
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| Features:
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| *Secretory cells (line gland lumen) have columnar morphology.
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| *May have "apical snouts".
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| **Blebs or round balls eosinophilic material appear to be adjacent to the cell at their luminal surface.
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| **The snouts are attached to the cell-- appear as round ball only in the plane of section.
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| *Cytoplasm +/-eosinophilia.
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| *Often purple luminal calcifications
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| DDx:
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| *Flat epithelial atypia (>2 cell layers).{{Fact}}
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| **If the columnar cells shows low to intermediate grade atypia the process is termed "flat epithelial atypia"
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| **If higher grade atyia is present the lesion is termed "flat DCIS" (clinging carcinoma)
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| Image:
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| *[http://webpathology.com/image.asp?case=652&n=1 Columnar cell change (webpathology.com)].
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| ==Gynecomastoid hyperplasia== | | ==Gynecomastoid hyperplasia== |
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| ==Sclerosing adenosis== | | ==Sclerosing adenosis== |
| ===General===
| | {{Main|Sclerosing adenosis of the breast}} |
| *Can be scary... can look like [[ductal carcinoma]].
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| *Derived from ''sclerosing''<ref>URL: [http://dictionary.reference.com/browse/sclerosis http://dictionary.reference.com/browse/sclerosis]. Accessed on: 16 March 2011.</ref> (hardening) and ''adenosis'' (glandular enlargement).
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| **Think ''scaring'' + ''lotsa glands'' and you're pretty close.
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| *Management: follow-up, no further treatment.<ref>URL: [http://www.breastcancercare.org.uk/breast-cancer-information/breast-awareness/benign-breast-conditions/sclerosing-lesions http://www.breastcancercare.org.uk/breast-cancer-information/breast-awareness/benign-breast-conditions/sclerosing-lesions]. Accessed on: 30 April 2012.</ref>
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| ===Microscopic===
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| Features:
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| *Acini are smaller than usual and there are more of them.
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| **Acini often slit-like.
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| *Fibrosis (scleroses) - pink on H&E surrounds the acini.
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| **Can mimic a [[desmoplastic reaction]].
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| Notes:
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| *The acini should:
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| **Be in lobular arrangements, i.e. in groups (benign appearance at low power) - '''key feature'''.
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| **Have two cell layers like well-behaved breast glands do.
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| DDx:
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| *Low-grade ductal carcinoma.
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| *[[Tubular adenoma of the breast]].
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| *[[Adenomyoepithelioma]].<ref name=chu>Chu et al. (2006). Adenomyoepithelioma of the Breast — A Case Report. Tzu Chi Med J. Vol. 18 No. 1. URL:URL: [http://www.tzuchi.com.tw/file/tcmj/95-1/2-8.pdf http://www.tzuchi.com.tw/file/tcmj/95-1/2-8.pdf]. Accessed on: 28 April 2012.</ref>
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| ==Flat epithelial atypia== | | ==Flat epithelial atypia== |