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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]

Overview

Classification

Classification of breast lumps based on epithelial hyperplasia[1]

  • Approximately 65% of all benign breast disease considered as nonproliferative(NP)with relative cancer risk of 1.2, 1.4 times:
    • Simple cyst
    • Fibrosis
    • Fibroadenoma (simple)
    • Columnar alteration (Simple)
    • Apocrine metaplasia (simple)
    • Mild ductal hyperplasia
  • Approximately 30% of total are classifed as proliferative disease(PD) with relative cancer risk of 1.7, 2.1 times
    • Usual ductal hyperplasia
    • Sclerosing adenosis
    • Columnar hyperplasia
    • papilloma
    • Radical scar
  • Approximately 5% to 8% of the rest regarded to PD with atypia with relative cancer risk more than 4 times
    • Atypical lobar hyperplasia
    • Lobular carcinoma in situ
    • Atypical ductal hyperplasia
  • Unclear risk
    • Mucocele like tumor
    • Apocrine atypia
    • Secretory atypia

Classification of benign breast lesion regarding to histological region:[2]

  • Terminal and lobular ducts
    • Acinar distention
      • Cyst
    • Intralobular connective tissue proliferation
      • Sclerosing adenosis
      • Fibroadenoma
      • Phyllodes tumor
      • Hamartoma
    • Epithelial changes in terminal duct lobaular units (TDLU)
      • Apocrine metaplasia
      • Ductal and lobular hyperplasia, usual and typical
      • Papillomatosis
      • Intracystic papilloma
  • Ductal system
    • Ductal ectasia
    • Intraductal papilloma
  • Lesion of different origin
    • Fatty tissue lesion
      • Lipoma
      • Liponecrosis
    • Fibrous tissue lesions
      • Focal fibrosis
      • Diabetic mastopathy
      • Pseudoangiomatous stromal hyperplasia (PASH)
      • Myofibroblastoma
    • Vascular origin
      • Hemangioma
    • Inflammatory origin
      • Mastitis/abscess
      • Tuberclosis and sarcoidosis
      • Foreign body granuloma and siliconoma
    • Lymph node origin
      • Inflammatory lymoh nodes

Risk factors

Associated risk factors leading to female breast cancer:

  • Age: probability of breast cancer from birth to 39 years; 1 in 202, from 40 to 59 years; 1 in 26, from 60 to 69 years; 1 in 28.
  • Personal history of breast cancer
  • Breast pathology: PD with atypia has greater risk of developing to breast cancer in comparison of PD.
  • Family history: greater breast cancer risk in women with first degree relatives with breast cancer under 50 years old.
  • Genetic predisposition
    • High risk
      • BRCA1
      • BRCA2
    • Moderate risk
      • Homozygous ataxia-telangiectasia (ATM)
      • Somatic mutation in CHEK2
      • BRCA1 modifier gene: BRIP1
      • BRCA2 modifier gene: PALB2

References

  1. Hartmann LC, Sellers TA, Frost MH, Lingle WL, Degnim AC, Ghosh K; et al. (2005). "Benign breast disease and the risk of breast cancer". N Engl J Med. 353 (3): 229–37. doi:10.1056/NEJMoa044383. PMID 16034008.
  2. Lanyi, M (2003). Mammography : diagnosis and pathological analysis. Berlin New York: Springer-Verlag. ISBN 9783540441137.