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Identify the risks of benign lesions in relation to developing subsequent breast cancer. Benign breast diseases constitute a heterogeneous group of lesions including developmental abnormalities, inflammatory lesions, epithelial and stromal proliferations, and neoplasms. In this review, common benign lesions are summarized and their relationship to the development of subsequent breast cancer is emphasized.
It is well known that certain types of pre-malignant lesions can predispose some women to increased risk of breast cancer. These certain types of pre-malignant lesions are generally classified as high-risk breast lesions. These lesions are morphologically, radiologically, histologically and clinically heterogeneous and early identification can help to prevent progression to invasive cancers.
Sclerosing adenosis is a benign, usually asymptomatic lobulocentric proliferative process that involves both the epithelial and the mesenchymal component of the breast. It is commonly an incidental finding in perimenopausal women undergoing screening mammography. We reported on two patients with sclerosing adenosis assessed with mammography, ultrasound, and contrast-enhanced magnetic resonance imaging. Case 1 was a year-old woman with a palpable lesion in her right breast that was depicted as an irregular mass on contrast-enhanced magnetic resonance imaging.
Over one million American women have a benign breast biopsy annually. Sclerosing adenosis SA is a common, but poorly understood benign breast lesion demonstrating increased numbers of distorted lobules accompanied by stromal fibrosis. Few studies of its association with breast cancer have been conducted, with contradictory results.
It is sometimes placed under the category of borderline breast disease. Many women with sclerosing adenosis experience recurring pain that tends to be linked to the menstrual cycle. In most cases, sclerosing adenosis is detected during routine mammograms or following breast surgery.
A year-old female presented with an abnormal screening mammogram, and subsequent diagnostic mammogram and ultrasound appearance were nonconclusive. MRI was recommended for further evaluation and showed a Type 3 enhancing kinetic curve highly sug- gestive of malignancy. Therefore, core biopsy was performed and revealed sclerosing adenosis.
Tubular carcinoma Infiltrating ductal carcinoma Sclerosing adenosis, ductal adenoma, nipple adenoma Tubular Carcinoma Radial Scar Single layer of cells Often multiple cell layers No myoepithelial cells Myoepithelial cells present Frequent infiltration of fat by naked tubules No bare infiltration of fat No epithelial hyperplasia May show epithelial hyperplasia Both have a stellate configuration with radiating fibrous arms and fibroelastotic stroma. Infiltrating Ductal Carcinoma Radial Scar Cells may show various levels of atypia Cytologically bland cells No myoepithelial cells Myoepithelial cells present Frequent infiltration of fat by naked tubules No bare infiltration of fat May show various infiltrative patterns Stellate configuration Radial ScarSclerosing Adenosis, Ductal Adenoma and Nipple Adenoma. Radial scar in the absence of associated DCIS is considered a marker of increased risk of carcinoma rather than a precursor lesion In an excisional biopsy, margins are not relevant if it is the only lesion Relative risk for development of invasive breast carcinoma.