A 27 year old female feels a lump in her breast and schedules an appointment with her doctor for examination. A tissue biopsy is taken and examined, with multiple areas showing only benign features. Which of the following findings implies an increased risk of subsequently developing invasive carcinoma?
Sclerosing adenosis is a type of proliferative fibrocystic disease that is often seen with other variants of fibrocystic disease. It is a proliferation of small ducts and myoepithelial cells near the terminal duct lobular unit. It also is characterized by fibrosis that distos the glands and lobules into a whorled pattern. The demonstration of this on biopsy, as with other proliferative fibrocystic changes, implies an increased risk for subsequent invasive breast cancer. Apocrine metaplasia is the term used to describe a transformation of ductal epithelial cells to eosinophilic cells resembling apocrine sweat gland epithelium. This is a benign, common, non-proliferative change that is not associated with increased cancer risk. A blue-domed cyst of Bloodgood is a fluid-filled cyst, sometimes up to 5 cm in size, that appears blue grossly before it is incised. When incised, the fluid is serous and dark- colored. These cysts are pa of benign non-proliferative fibrocystic disease and do not carry increased cancer risk. Duct ectasia is characterized by a large dilated duct with inspissated material. it is associated with periductal inflammation and fibrosis of the large collecting ducts under the areola. It is common in elderly women, although the cause is not clear. There is no increased risk of cancer. Ref: Wyatt C., Kemp W.L., Moos P.J., Burns D.K., Brown T.G. (2008). Chapter 17. Pathology of the Male and Female Reproductive Tract and Breast. In C. Wyatt, W.L. Kemp, P.J. Moos, D.K. Burns, T.G. Brown (Eds), Pathology: The Big Picture.
Apocrine metaplasia
Blue-domed cysts of Bloodgood
Duct ectasia
Sclerosing adenosis