Download MBBS Surgery Presentations 8 Benign Breast Disease Lecture Notes

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BENIGN BREAST DISEASE

Mammary ductogram demonstrating lobules


Pre-menarchal ductule

Terminal ductal-

lobular unit

BREAST DEVELOPMENT

Menarche and Reproductive Cycles:
Pulsed estrogen exposure causes rapid growth, elongation

and branching

Term pregnancy leads to terminal differentiation and stops

growth

End bud epithelial tissue undergoes cyclic proliferation

Breast feeding is associated with a lower risk of breast

cancer


Normal breast in

pregnancy and

after

BREAST DEVELOPMENT

Involution: Changes of involution begin after cessation of

lactation and continue through menopause

Competing involution and proliferative processes are

patchy and increased in peri-menopause and with HRT

Hyperplasia with atypia and DCIS peak in this period


Involutional and

cystic change

DEFINITION

It is spectrum of diseases that are

histologically variation of normal
breast anatomy with no evidence of
malignancy on histopathological
examinations.


BENIGN BREAST DISEASE
It includes:

vCongenital anomalies
vInflammatory lesion
vANDI
vNon breast diseases

BENIGN BREAST DISEASE: IMPORTANCE

10 times more frequent than carcinoma in

patients presenting to physician.

70% of lumps are benign but 30 % can have

malignancy or malignant potential.

Anxiety & stress to patients.

Mostly requires reassurance and some

pharmacologic treatments only.


CONGENITAL ANOMALIES

Polymastia,

Polythelia

Amastia

Poland syndrome

Symmastia.

INFECTIOUS AND INFLAMMATORY BREAST

DISEASE

Cellulitis, mastitis
Abscess

Surgical drainage

Chronic subareolar abscess

Complete excision of sinus tract
Recurrence is common

Mondor's disease

Phlebitis of the thoracoepigastric vein.


ANDI

CLASSIFICATION : HISTOLOGICAL

? Non Proliferative Lesion

?Simple Cyst
?Complex cyst


SIMPLE CYST

CLASSIFICATION : HISTOLOGICAL

? Proliferative Lesions? Without

Atypia

?Ductal hyperplasia
?Fibroadenoma
?Intraductal papilloma
?Sclerosing Adenoma
?Radial Scars
CLASSIFICATION : HISTOLOGICAL

? Proliferative Lesions With Atypia-

?Atypical ductal hyperplasia
?Atypical lobular hyperplasia

CLASSIFICATION: MALIGNANT POTENTIAL

? Lesions with Increased Risk of Ca

?Ductal hyperplasia

?Sclerosing adenosis

?Atypical hyperplasia

?Radial scars
CLASSIFICATION: MALIGNANT POTENTIAL

? Lesions with no Increased risk of Ca

?Fibrocystic disease
?Duct ectasia
?Solitary papillomas
?Simple fibroadenomas
?Mastitis or breast abscess
?Galactocele
?Fat necrosis
?Lipoma

SYNDROMIC APPROACH:

? Mastalgia

?Cyclic
?Non Cyclic


SYNDROMIC APPROACH:
? Tumors and Masses

?Nodularity or glandular
?Cysts
?Galactoceles
?Fibroadenoma
?Sclerosing Adenosis
?Lipoma
?Harmatoma
?Cystosarcoma Phylloides


SYNDROMIC APPROACH:

BBD


(Triple test)

SYNDROMIC APPROACH
? Nipple discharge

?Galactorrhea
?Abnormal nipple discharge