Download MBBS Surgery Presentations 8 Benign Breast Disease Lecture Notes

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Pre-menarchal ductule

Terminal ductal-

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lobular unit

BREAST DEVELOPMENT

Menarche and Reproductive Cycles:

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Pulsed estrogen exposure causes rapid growth, elongation

and branching

Term pregnancy leads to terminal differentiation and stops

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growth

End bud epithelial tissue undergoes cyclic proliferation

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Breast feeding is associated with a lower risk of breast

cancer

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Normal breast in

pregnancy and

after

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BREAST DEVELOPMENT

Involution: Changes of involution begin after cessation of

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lactation and continue through menopause

Competing involution and proliferative processes are

patchy and increased in peri-menopause and with HRT

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Hyperplasia with atypia and DCIS peak in this period


Involutional and

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cystic change

DEFINITION

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It is spectrum of diseases that are

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

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examinations.


BENIGN BREAST DISEASE
It includes:

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vCongenital anomalies
vInflammatory lesion
vANDI
vNon breast diseases

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BENIGN BREAST DISEASE: IMPORTANCE

10 times more frequent than carcinoma in

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patients presenting to physician.

70% of lumps are benign but 30 % can have

malignancy or malignant potential.

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Anxiety & stress to patients.

Mostly requires reassurance and some

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pharmacologic treatments only.


CONGENITAL ANOMALIES

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Polymastia,

Polythelia

Amastia

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Poland syndrome

Symmastia.

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INFECTIOUS AND INFLAMMATORY BREAST

DISEASE

Cellulitis, mastitis

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Abscess

Surgical drainage

Chronic subareolar abscess

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Complete excision of sinus tract
Recurrence is common

Mondor's disease

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Phlebitis of the thoracoepigastric vein.


ANDI

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CLASSIFICATION : HISTOLOGICAL

? Non Proliferative Lesion

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?Simple Cyst
?Complex cyst


SIMPLE CYST

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CLASSIFICATION : HISTOLOGICAL

? Proliferative Lesions? Without

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Atypia

?Ductal hyperplasia
?Fibroadenoma
?Intraductal papilloma

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?Sclerosing Adenoma
?Radial Scars
CLASSIFICATION : HISTOLOGICAL

? Proliferative Lesions With Atypia-

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?Atypical ductal hyperplasia
?Atypical lobular hyperplasia

CLASSIFICATION: MALIGNANT POTENTIAL

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? Lesions with Increased Risk of Ca

?Ductal hyperplasia

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?Sclerosing adenosis

?Atypical hyperplasia

?Radial scars

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CLASSIFICATION: MALIGNANT POTENTIAL

? Lesions with no Increased risk of Ca

?Fibrocystic disease

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?Duct ectasia
?Solitary papillomas
?Simple fibroadenomas
?Mastitis or breast abscess
?Galactocele

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?Fat necrosis
?Lipoma

SYNDROMIC APPROACH:

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? Mastalgia

?Cyclic
?Non Cyclic

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SYNDROMIC APPROACH:
? Tumors and Masses

?Nodularity or glandular

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?Cysts
?Galactoceles
?Fibroadenoma
?Sclerosing Adenosis
?Lipoma

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?Harmatoma
?Cystosarcoma Phylloides


SYNDROMIC APPROACH:

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BBD


(Triple test)

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SYNDROMIC APPROACH
? Nipple discharge

?Galactorrhea

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?Abnormal nipple discharge