Faculty of Allied Medical Sciences

1. Faculty of Allied Medical Sciences Histopathology and Cytology (MLHC-201)

2. BREAST PATHOLOGYSupervision:Prof. Dr. NohaRagab

3. Intended Learning Outcomes By the end of this lecture the student should know 1-the different proliferative and non-proliferative breast lesion 2-The types of different inflammations 3-The different benign breast tumours

4. NORMAL BREAST

5. Breast lobules Main duct Normal breast tissue

6. Fibrocystic diseases of breast

7. Fibrocystic changes: • Clinical presentation: • Produce palpable “lumps” • They may cause nodularity

8. Fibrocystic diseases: • They can be subdivided into non-porliferative and proliferative patterns.

9. Non-proliferative fibrocystic change • Cysts and fibrosis: • Characterized by an increase in fibrous stroma associated with dilation of ducts and formation of cysts of various sizes.

10. Fibrocystic changes of breast

11. Proliferative fibrocystic change • Epithelial hyperplasia: • It is proliferative lesion within the ductules, the terminal ducts and sometimes the lobules of the breast. • Sclerosing adenosis: • This variant is less common, but it is significant because its clinical features are similar to those of carcinoma.

12. Epithelial hyperplasia Sclerosing adenosis

13. FIBROCYSTIC DISEASES OF BREAST NON-PROLIFERATIVE FIBROCYSTIC DISEASE PROLIFERATIVE FIBROCYSTIC DISEASE CYSTS FORMATION AND FIBROSIS • EPITHELIAL DUCT HYPERPLASIA • SCLEROSING ADENOSIS

14. Inflammations of breast

15. Inflammations of breast • Acute mastitis • Fat necrosis • Mammary duct ectasia

16. Fat necrosis: • Often related to trauma • Produce a palpable mass

17. Acute mastitis: • Common during lactation • They usually cause pain and tenderness in the involved areas. • They are not associated with increased risk of cancer.

18. Mammary duct ectasia: • Granulomatous reaction; this generally follows acute mastitis and is a localized granulomatous reaction. In some instances associated with ectasia of the ducts (cystic dilatation) • Encountered in women in their 40s and 50s. • Mammary duct ectasia leads to hardness of the breast substance mimicking the changes caused by carcinoma.

19. Tumors of the breast

20. Benign tumors of breast

21. Benign tumors of breast • Fibro adenoma • Phylloids tumour • Intra ductal papilloma

22. Fibroadenoma • Most common benign neoplasms of the female breast. • Almost never become malignant. • Peak incidence is in the third decade of life. • Presents as a solitary, discrete, movable mass.

23. Microscopically:

24. Fibroadenoma

25. Phylloids tumour • Much less common than fibroadenomas. • Arise from the periductal stroma and from preexisting fibroadenomas. • On gross section they exhibit leaf-like clefts and slits, that is why they called phylloids tumors. • Microscopically: increased cellularity and stromal overgrowth

26. Phyllodes tumor

27. Intra-ductal papilloma • A benign neoplastic papillary growth within a duct. • Solitary and found within the principal lactiferous ducts or sinuses. • Microscopically: benign papillary growth within a main lactiferous duct

28. Clinically: • Appearance of serous or bloody nipple discharge • Presence of small sub-areolar tumour

29. Intra-ductal papilloma

30. Intra-ductal papilloma

31. Questions Complete : 1- Fibrocystic diseases can be subdivided into ……… 2- The inflammations of the breast include ……… 3- The benign tumors of the breast include ……… 4- The most common benign neoplasms of the female breast are ……….. 5- Principal lactiferous ducts or sinuses exhibit the growth of …….

32. Assignments Rheumatic fever أمل رأفت محمد امنية بدوي أحمد نعينع امنية صبري محمد الجمل Hypertension امنية عبد الحي عبد الوهاب محمد علي أميرة رفعت حسن علي أحمد أميرة صلاح الشحات ابراهيم حسين

33. Thank You