Clinical Pathology: Benign Breast Diseases (Mastitis, Fibrocystic

Benign Breast Diseases The female and male breasts are anatomically similar, though adult female breasts have more adipose tissue and a more developed ductal system; this is particularly true in those who are pregnant or lactating. The physiological role of the breast is to produce and transport milk during the hormonally regulated process of lactation (for more on hormonal regulation, click here: prolactin). "Benign breast disease" is an umbrella term for non-malignant lesions; it is more common in premenopausal women, whereas malignant lesions are more common in postmenopausal women. Lesions may be discovered via imaging, or patients may present with pain, masses, or nipple discharge. Symptoms may be cyclical, due to changes in estrogen levels during the menstrual cycle. To diagnose non-malignant lesions and rule out the possibility of breast cancer, we can use imaging (such as mammograms and MRI), biopsy, and conduct nipple discharge analyses. Breast anatomy & lesion locations First, we show the outline of the breast, which is covered in skin. The majority of the breast tissue comprises adipose and connective tissues. The ductal system: - Lobular stroma surrounds the lobules, which are the glands that produce milk. - Lobuless drain to terminal ducts, which drain to the main ducts that carry milk to the nipple. - The lactiferous sinus is in the nipple; the sinus is a dilation of the duct. We also show some smooth muscle tissue to the sides of the nipple. Pathologies by location: - In the lobular stroma we find fibroadenomas and phyllodes tumors. - In the lobules and terminal ducts, we find fibrocystic changes and carcinomas. - In the lactiferous sinus and main ducts, we find mastitis, intraductal papilloma, and Paget disease of the breast. - In the Interlobular stroma and fat, we find fat necrosis. Benign Breast Diseases Fibrocystic changes: Fibrocystic changes are the most common benign breast condition; about half of premenopausal women over age 30 have some deg

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