Angiomatosis ; pathology ; Breast ; pathology ; Breast Diseases ; pathology ; Female ; Humans ; Hyperplasia ; pathology

Recently we experienced a case manifested by a lump in both breast that mimicked carcinoma but was found to be a vasculitis of the giant cell type. Our case was characterized histologically by granulomatous arteritis involving small to medium sized arteries of the breast without involvement of the temporal artery. We described the clinical and pathologic features of a case of giant cell arteritis of the breast and reviewed the eight previously reported cases in foreign literature.
Aged ; Breast/pathology ; Breast Diseases/*pathology ; Case Report ; Female ; Human ; Temporal Arteritis/*pathology

Irregular hypoechoic masses in the breast do not always indicate malignancies. Many benign breast diseases present with irregular hypoechoic masses that can mimic carcinoma on ultrasonography. Some of these diseases such as inflammation and trauma-related breast lesions could be suspected from a patient's symptoms and personal history. Careful ultrasonographic examination and biopsy could help to differentiate these from malignancies.
Abscess/ultrasonography ; Breast Diseases/pathology ; Breast Neoplasms/pathology/*ultrasonography ; Carcinoma/pathology/ultrasonography ; Female ; Fibroadenoma/pathology/ultrasonography ; Fibrocystic Breast Disease/pathology/ultrasonography ; Granulomatous Mastitis/pathology/ultrasonography ; Humans ; Ultrasonography, Mammary

Adenocarcinoma, Mucinous ; pathology ; Breast ; pathology ; Breast Diseases ; pathology ; Breast Neoplasms ; pathology ; Carcinoma, Papillary ; pathology ; Carcinoma, Signet Ring Cell ; pathology ; Cystadenocarcinoma, Mucinous ; pathology ; Diagnosis, Differential ; Female ; Fibroadenoma ; pathology ; Fibrosarcoma ; pathology ; Humans ; Mucocele ; pathology ; Myxosarcoma ; pathology

Amyloidosis is a rare disease characterized by the formation of pathological protein deposits in organs or tissues. It is typically a systemic disease which can occur in a localized form. Amyloidosis of the breast is uncommon. Common mammographic findings of breast amyloidosis are multiple nodules with or without calcifications. We report a case of primary localized breast amyloidosis presenting suspicious microcalcifications on mammography without associated masses. Mammography in a 72-year-old woman displayed multiple, linearly distributed, irregular and rod-like calcifications in the subareolar area of the left breast. The patient underwent surgical excision under mammo-guided needle localization and the pathology was confirmed to be breast amyloidosis.
Aged ; Amyloidosis/pathology/*ultrasonography ; Breast/pathology ; Breast Diseases/pathology/*ultrasonography ; Calcinosis/*diagnosis ; Diagnosis, Differential ; Female ; Humans ; Ultrasonography, Mammary

OBJECTIVETo study the efficacy and complications of the method for reduction mammaplasty in patients with breast benign diseases.

METHODSFrom November 1980 to December 2001, reduction mammaplasty was performed in 27 patients with breast hypertrophy, ptosis and benign diseases. The operation methods were selected according to the characters of the diseases and the extent of breast hypertrophy and ptosis. 9 patients received reduction mammaplasty using an inferior pyramidal pedicle technique; 16 patients received Mckissock vertical bipedicle technique and 2 patients received the bicyclic incision technique.

RESULTSThe successful rate was 94.2%. Three breasts developed areola necrosis in Mckissock. Symptoms caused by breast hypertrophy and benign diseases were improved apparently.

CONCLUSIONReduction mammaplasty is the best option for the treatment of breast hypertrophy and ptosis with benign diseases. The method of reduction mammaplasty should be taken individually.

Aged ; Breast ; pathology ; surgery ; Breast Diseases ; surgery ; Female ; Humans ; Hypertrophy ; surgery ; Mammaplasty ; methods

OBJECTIVETo find out the most effective and combined cytomorphologic criteria trying to set up an effective diagnostic model for breast ductal lesion in fine needle aspiration cytology (FNAC).

METHODSA total of 400 breast FNAC cases were collected with follow-up information of more than six years. A retrospective analysis including 104 non-proliferative breast diseases, 163 proliferative breast diseases and 133 carcinomas basing on the diagnostic results of surgical biopsies. Altogether, 60 cytomorphologic variables were counted for the evaluation of each case, including 4 main categories: the cellularity and components, natures of background, cellular arrangements and the cellular features. According to the quantity or the classification stage, the variables were semi-quantitatively scored. Multiple step-wise logistic regression (SPSS) and classification tree model (SAS) were performed to determine the significant and combined variables predictive for the diagnosis of non-proliferative lesion, proliferative breast diseases and carcinoma, respectively.

RESULTS(1) Among 400 benign and malignant cases studied, and basing on the result of analyses of multiple step-wise logistic regression system, intermingling of myoepithelial cells within the epithelial cluster (P < 0.05), presence of large epithelial cell cluster (P < 0.05), presence of small epithelial cell cluster (P < 0.05), cytoplasmic vacuoles (P < 0.05) and figures of "progressive intussusception" of cells (P < 0.1) were selected as the effectively differential diagnostic criteria for the benign and malignant lesions. However, according to the classification tree model, the most useful variable selected associating with the benign lesion was intermingling of myoepithelial cells within epithelial cluster. The diagnostic accuracy will be increased to 94.4%, if another criterion, presence of a big amount of large epithelial clusters, was used as the second useful variable in combination. Presence of a moderate to large amount of small epithelial cell clusters were indicative of proliferative lesion. If the criterion of myoepithelial cells intermingling within epithelial cluster was not found in the sample and associating with presence of small epithelial cell clusters, cytoplasmic vacuoles and figures of "progressive intussusception" of cells, mostly (81.3%), it would be considered as a case of carcinoma. (2) Among 267 benign non-proliferative and proliferative breast diseases studied, both the multiple step-wise logistic regression and classification tree model, presence of irregular intercellular spaces within the epithelial clusters (P = 0.001), loose epithelial clusters (P < 0.05) and hyperchromasia (P < 0.1) were selected as the significant differential diagnostic criteria for the proliferative lesion. The architectural variables and the amount of the abnormal cell features such as cell cluster formation were considered to be more important. A high frequency of presence of irregular intercellular spaces within the epithelial clusters and the amount of loose epithelial clusters indicated a higher possibility of a proliferative lesion. Presence of a single variable of irregular intercellular spaces within the epithelial clusters had the possibility of a benign lesion diagnosis up to 70.1% in all the proliferative breast disease cases collected in this series. If the frequency of irregular intercellular spaces increased to a moderate degree or even higher, the possibility of a benign lesion would be increased to 82.7%. The possibility of a proliferative breast disease would be reached to 87.5%, if both the criteria of irregular intercellular spaces and loosely arranged epithelial cell clusters were counted in combination. (3) The histological results of 35 lesions with atypical cytological features in FNAC specimens were predominantly a proliferative lesion of the breast (26 cases), and most of them were fibroadenoma with ductal hyperplasia. Occasionally, there might be a few benign cases complicating with lesions of atypical hyperplasia or carcinoma.

CONCLUSIONSIn breast FNAC diagnosis, a combined evaluation of significant variables and the amount of the variable involved are effective for the differential diagnosis between benign/malignant and non-proliferative/proliferative lesions. Lesion accompanying with atypical cellular features should avoid to be overdiagnosed as carcinoma, and biopsy for a histological diagnosis is indicative.

Biopsy, Fine-Needle ; methods ; Breast ; pathology ; Breast Diseases ; diagnosis ; pathology ; Breast Neoplasms ; diagnosis ; pathology ; Carcinoma, Ductal, Breast ; diagnosis ; pathology ; Cytodiagnosis ; Diagnosis, Differential ; Epithelial Cells ; pathology ; Female ; Fibroadenoma ; diagnosis ; pathology ; Follow-Up Studies ; Humans ; Hyperplasia ; Precancerous Conditions ; diagnosis ; pathology ; Retrospective Studies

Contrast-enhanced magnetic resonance imaging (MRI) of the breast is probably the most sensitive method for the detection of the pathology of the breast. It is an emerging technology that may revolutionize the management of women with known or suspected breast cancer. Recently, breast MRI has proven most useful in patients with proven breast cancer for the assessment of a multifocal/multicentric disease, chest wall involvement, chemotherapy response, or tumor recurrence or to identify the primary site in patients with occult breast cancer. False positive findings can pose a significance problem in the interpretation of a breast MRI. MRI examinations should be interpreted with an awareness of the pitfalls, false positive breast lesions, and artifacts that can affect on the image evaluation.
Artifacts ; Breast Diseases* ; Breast Neoplasms ; Breast* ; Drug Therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Pathology ; Recurrence ; Thoracic Wall

The development of ectopic breast tissue is attributable to the failure of primitive mammary tissue to regress after the development of the mammary ridge, except at pectoral breast sites, and is most often evident in the axillae. Several benign and malignant breast diseases have been reported in ectopic axillary breast tissues. The most common cancerous pathology of ectopic breast tissue is invasive ductal carcinoma. Ectopic breast cancer presenting with simultaneous primary cancer of the pectoral breast is extremely rare. Herein, we report an invasive micropapillary carcinoma of an axillary ectopic breast, combined with a synchronous ductal carcinoma in situ in the contralateral pectoral breast of a 61-year-old woman.
Axilla ; Breast Diseases ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Choristoma ; Female ; Humans ; Middle Aged ; Pathology

BACKGROUNDMicrocalcifications play a very important role in detection of breast cancer, especially early stage breast cancer. However, ambiguity still exists in understanding the relationship between radiological and pathological characteristics of microcalcifications. The definitive indication of a biopsy has not been established. The purpose of this study is to evaluate the relationship of classification of breast microcalcifications using full-field digital mammography to the pathological characteristics.

METHODSFor all the women an open biopsy had been conducted. One hundred and three mammographs showing clustered microcalcifications from 98 consecutive patients were reviewed along with their pathological records. To investigate the value of each criterion for the detection of cancer, univariate and multivariate analyses were performed on the entire sample and then on morphological subgroups.

RESULTSPathological examination showed 67 malignant lesions (65.05%) and 36 benign lesions (34.95%). In the univariate analysis, four radiological variables were significant: morphological type (P = 0.001), complicated by a mass (P = 0.002), number of microcalcifications per cluster (P = 0.02) and linear or triangular distribution of clusters (P = 0.009). In the multivariate analysis, two criteria remained significant: morphological type (P < 0.001) and complicated by a mass (P = 0.001). The percentage of malignancy was 37.0%, 60.0%, 78.8%, and 88.9%, respectively, for type 2 (regularly punctiform), type 3 (dusty), type 4 (irregularly punctiform) and type 5 (vermicular) microcalcifications (Le Gal's classification). The malignancy was 78.6% for microcalcifications complicated by a mass and 48.9% without a mass. The difference was significant (P < 0.05). The relationship between morphological types of microcalcifications and the pathological characteristics was also studied. In subgroups, type 3 (dusty) microcalcifications complicated by a mass (P = 0.001) or with the number of microcalcifications more than 10 (P = 0.024); and type 2 (regularly punctiform) with a diameter of the area over 20 mm (P = 0.024) or complicated by a mass (P = 0.025) were statistically significant as criteria for malignant tumour.

CONCLUSIONSMost cases of microcalcifications of type 4 or 5; type 3 complicated by a mass or with the number of microcalcifications more than 10; type 2 complicated by a mass or with a diameter of the area over 20 mm; are indicative of cancer. Open biopsy is recommended to acquire definitive pathological diagnosis for these cases. For the remainder of the morphological types, stereotaxic biopsy or followup should be considered.

Adult ; Aged ; Breast ; pathology ; Breast Diseases ; classification ; Breast Neoplasms ; diagnosis ; Calcinosis ; classification ; Female ; Humans ; Mammography ; Middle Aged ; Multivariate Analysis