Difference between revisions of "Breast pathology"

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Breast pathology (view source)

Revision as of 02:33, 9 February 2012

444 bytes removed ,  02:33, 9 February 2012
→‎Fibroadenoma: more
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Management:
Management:
*Local excision (without a large margin).
*Local excision -- without a large margin.


===Microscopic===
===Microscopic===
Features (fibroadenoma not otherwise specified):
Features:<ref name=Ref_BP110>{{Ref BP|110}}</ref>
*Abundant (intralobular) stroma - most '''important feature'''.
*Abundant (intralobular) stroma - most '''key feature'''.
**Stroma is usually white/pale, i.e. [[myxoid stroma|myxoid]], on H&E (normal stroma is pink).
**Stroma is usually:
***May be hyalinized (dark pink) if infarcted.
***White/pale, i.e. [[myxoid stroma|myxoid]], on H&E (normal stroma is pink).
*Compression of glandular elements -- very commonly seen.
****May be hyalinized (dark pink) if infarcted.
***Paucicellular - typical.
*Compression of glandular elements - very commonly seen.
**Glandular elements have at least two cell layers - epithelial and myoepithelial.


DDx:
DDx:
*[[Phyllodes tumour]].
*[[Phyllodes tumour]] - long slit-like spaces (seen grossly), stroma is more cellular.
**Stroma is more cellular than in fibroadenoma.
**+/-Mitoses,
**May have mitoses.
**+/-"Stromal overgrowth" = large area where there is a 'loss of glands'.
**"Stromal overgrowth" large area where there is a 'loss of glands'.
**Patients with phyllodes tumour are usually older than those with fibroadenoma.
*Sarcoma.
*Sarcoma.
*[[PASH]].
*[[PASH]].
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Image:
Image:
*[http://radiographics.rsna.org/content/27/suppl_1/S101/F40.expansion.html Infarcted fibroadenoma (rsna.org)].<ref name=pmid18180221>{{Cite journal  | last1 = Sabate | first1 = JM. | last2 = Clotet | first2 = M. | last3 = Torrubia | first3 = S. | last4 = Gomez | first4 = A. | last5 = Guerrero | first5 = R. | last6 = de las Heras | first6 = P. | last7 = Lerma | first7 = E. | title = Radiologic evaluation of breast disorders related to pregnancy and lactation. | journal = Radiographics | volume = 27 Suppl 1 | issue =  | pages = S101-24 | month = Oct | year = 2007 | doi = 10.1148/rg.27si075505 | PMID = 18180221 }}</ref>
*[http://radiographics.rsna.org/content/27/suppl_1/S101/F40.expansion.html Infarcted fibroadenoma (rsna.org)].<ref name=pmid18180221>{{Cite journal  | last1 = Sabate | first1 = JM. | last2 = Clotet | first2 = M. | last3 = Torrubia | first3 = S. | last4 = Gomez | first4 = A. | last5 = Guerrero | first5 = R. | last6 = de las Heras | first6 = P. | last7 = Lerma | first7 = E. | title = Radiologic evaluation of breast disorders related to pregnancy and lactation. | journal = Radiographics | volume = 27 Suppl 1 | issue =  | pages = S101-24 | month = Oct | year = 2007 | doi = 10.1148/rg.27si075505 | PMID = 18180221 }}</ref>
====Phyllodes tumour vs. fibroadenoma====
Histology of phyllodes:
* More cellular.
* More mitoses.
* More nuclear pleomorphism.
* Stromal overgrowth - epithelial elements absent in one low power field (x40).
* Infiltrative borders.
* Long/large slit-like spaces - '''key feature'''.
** Small foci of long slit-like space may exist -- how much... no definition.
Epidemiology:
* Phyllodes = older patients (usually)
Tx:
* Wide excision for phyllodes vs. local excision for fibroadenoma.


====Variants====
====Variants====
Michael
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