Breast lumps classification: Difference between revisions
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[[Breast lumps]] may be classified according to [[epithelial]] [[hyperplasia]] into 3 subtypes: non-proliferative, proliferative disease and proliferative disease without [[atypia]]. | [[Breast lumps]] may be classified according to [[epithelial]] [[hyperplasia]] into 3 subtypes: non-proliferative, proliferative disease and proliferative disease without [[atypia]]. [[Breast lumps]] may be classified into 3 sub-types based on [[histological]] regions: [[lobular]] region, ductal region, different origins. | ||
[[Breast lumps]] may be classified into 3 | |||
==Classification== | ==Classification== | ||
'''Classification of | '''Classification of breast lumps based on epithelial hyperplasia:'''<ref name="pmid16034008">{{cite journal| author=Hartmann LC, Sellers TA, Frost MH, Lingle WL, Degnim AC, Ghosh K et al.| title=Benign breast disease and the risk of breast cancer. | journal=N Engl J Med | year= 2005 | volume= 353 | issue= 3 | pages= 229-37 | pmid=16034008 | doi=10.1056/NEJMoa044383 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16034008 }} </ref><ref name="pmid1734106">{{cite journal| author=London SJ, Connolly JL, Schnitt SJ, Colditz GA| title=A prospective study of benign breast disease and the risk of breast cancer. | journal=JAMA | year= 1992 | volume= 267 | issue= 7 | pages= 941-4 | pmid=1734106 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1734106 }}</ref><ref name="pmid39659322">{{cite journal| author=Dupont WD, Page DL| title=Risk factors for breast cancer in women with proliferative breast disease. | journal=N Engl J Med | year= 1985 | volume= 312 | issue= 3 | pages= 146-51 | pmid=3965932 | doi=10.1056/NEJM198501173120303 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3965932 }}</ref> | ||
*Approximately 65% of all benign breast disease considered as | *Approximately 65% of all benign breast disease considered as non-proliferative (NP) with relative cancer risk of 1.2 - 1.4 times: | ||
**[[Cyst]] | **[[Cyst]] (most common)<ref name="pmid7110289">{{cite journal| author=Love SM, Gelman RS, Silen W| title=Sounding board. Fibrocystic "disease" of the breast--a nondisease? | journal=N Engl J Med | year= 1982 | volume= 307 | issue= 16 | pages= 1010-4 | pmid=7110289 | doi=10.1056/NEJM198210143071611 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7110289 }} </ref> | ||
**[[Fibrosis]] | **[[Fibrosis]] | ||
** [[Fibroadenoma]] (simple) | ** [[Fibroadenoma]] (simple) | ||
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** [[Apocrine]] [[metaplasia]] (simple) | ** [[Apocrine]] [[metaplasia]] (simple) | ||
** Mild ductal [[hyperplasia]] | ** Mild ductal [[hyperplasia]] | ||
* Approximately 30% of total are classified as (PD) with relative cancer risk of 1.7 | * Approximately 30% of total are classified as proliferative disease (PD) with relative cancer risk of 1.7 - 2.1 times:<ref name="pmid3965932">{{cite journal| author=Dupont WD, Page DL| title=Risk factors for breast cancer in women with proliferative breast disease. | journal=N Engl J Med | year= 1985 | volume= 312 | issue= 3 | pages= 146-51 | pmid=3965932 | doi=10.1056/NEJM198501173120303 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3965932 }}</ref> | ||
** Usual ductal [[hyperplasia]] | ** Usual ductal [[hyperplasia]] | ||
** Sclerosing adenosis | ** [[Sclerosing adenosis]] | ||
** Columnar [[hyperplasia]] | ** Columnar [[hyperplasia]] | ||
** [[ | ** [[Papilloma]] | ||
** Radical scar | ** Radical scar | ||
* Approximately 5% to 8% of the rest regarded | * Approximately 5% to 8% of the rest are regarded as PD with [[atypia]] and relative cancer risk more than 4 times:<ref name="pmid6275978">{{cite journal| author=Page DL, Dupont WD, Rogers LW, Landenberger M| title=Intraductal carcinoma of the breast: follow-up after biopsy only. | journal=Cancer | year= 1982 | volume= 49 | issue= 4 | pages= 751-8 | pmid=6275978 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6275978 }}</ref> | ||
** Atypical lobar [[hyperplasia]] | ** Atypical lobar [[hyperplasia]] | ||
** [[Lobular]] [[carcinoma]] [[in situ]] | ** [[Lobular]] [[carcinoma]] [[in situ]] | ||
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** [[Apocrine]] [[atypia]] | ** [[Apocrine]] [[atypia]] | ||
** Secretory [[atypia]] | ** Secretory [[atypia]] | ||
'''Classification of [[benign breast lesion]] | '''Classification of [[benign breast lesion]] according to histological region''':<ref>{{cite book | last = Lanyi | first = M | title = Mammography : diagnosis and pathological analysis | publisher = Springer-Verlag | location = Berlin New York | year = 2003 | isbn = 9783540441137 }}</ref> | ||
*Terminal and [[lobular]] ducts | *Terminal and [[lobular]] ducts | ||
**[[Acinar]] distention | **[[Acinar]] distention | ||
***[[Cyst]] | ***[[Cyst]] | ||
**Intralobular connective tissue proliferation | **Intralobular connective tissue proliferation | ||
***Sclerosing adenosis | ***[[Sclerosing adenosis]] | ||
***[[Fibroadenoma]] | ***[[Fibroadenoma]] | ||
***[[Phyllodes tumor]] | ***[[Phyllodes tumor]] | ||
***[[Hamartoma]] | ***[[Hamartoma]] | ||
**Epithelial changes in terminal duct [[lobular]] units (TDLU) | **[[Epithelial]] changes in terminal duct [[lobular]] units (TDLU) | ||
***[[Apocrine]] [[metaplasia]] | ***[[Apocrine]] [[metaplasia]] | ||
***Ductal and [[lobular]] [[hyperplasia]], usual and typical | ***Ductal and [[lobular]] [[hyperplasia]], usual and typical | ||
| Line 58: | Line 55: | ||
**[[Fibrous]] tissue lesions | **[[Fibrous]] tissue lesions | ||
***Focal [[fibrosis]] | ***Focal [[fibrosis]] | ||
***[[Diabetic]] mastopathy | ***[[Diabetic]] mastopathy or lymphocytic mastitis or lymphocytic mastopathy<ref name="pmid16297091">{{cite journal| author=Lai EC, Chan WC, Ma TK, Tang AP, Poon CS, Leong HT| title=The role of conservative treatment in idiopathic granulomatous mastitis. | journal=Breast J | year= 2005 | volume= 11 | issue= 6 | pages= 454-6 | pmid=16297091 | doi=10.1111/j.1075-122X.2005.00127.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16297091 }}</ref><ref name="pmid11772912">{{cite journal| author=Kudva YC, Reynolds C, O'Brien T, Powell C, Oberg AL, Crotty TB| title="Diabetic mastopathy," or sclerosing lymphocytic lobulitis, is strongly associated with type 1 diabetes. | journal=Diabetes Care | year= 2002 | volume= 25 | issue= 1 | pages= 121-6 | pmid=11772912 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11772912 }}</ref> | ||
***Pseudoangiomatous [[stromal]] [[hyperplasia]] (PASH) | ***Pseudoangiomatous [[stromal]] [[hyperplasia]] (PASH) | ||
***Myofibroblastoma | ***Myofibroblastoma | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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Latest revision as of 20:42, 29 July 2020
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Breast lumps classification On the Web |
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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
Breast lumps may be classified according to epithelial hyperplasia into 3 subtypes: non-proliferative, proliferative disease and proliferative disease without atypia. Breast lumps may be classified into 3 sub-types based on histological regions: lobular region, ductal region, different origins.
Classification
Classification of breast lumps based on epithelial hyperplasia:[1][2][3]
- Approximately 65% of all benign breast disease considered as non-proliferative (NP) with relative cancer risk of 1.2 - 1.4 times:
- Cyst (most common)[4]
- Fibrosis
- Fibroadenoma (simple)
- Columnar alteration (Simple)
- Apocrine metaplasia (simple)
- Mild ductal hyperplasia
- Approximately 30% of total are classified as proliferative disease (PD) with relative cancer risk of 1.7 - 2.1 times:[5]
- Usual ductal hyperplasia
- Sclerosing adenosis
- Columnar hyperplasia
- Papilloma
- Radical scar
- Approximately 5% to 8% of the rest are regarded as PD with atypia and relative cancer risk more than 4 times:[6]
- Atypical lobar hyperplasia
- Lobular carcinoma in situ
- Atypical ductal hyperplasia
- Unclear risk
Classification of benign breast lesion according to histological region:[7]
- Terminal and lobular ducts
- Acinar distention
- Intralobular connective tissue proliferation
- Epithelial changes in terminal duct lobular units (TDLU)
- Apocrine metaplasia
- Ductal and lobular hyperplasia, usual and typical
- Papillomatosis
- Intracystic papilloma
- Ductal system
- Lesion of different origin
- Fatty tissue lesion
- Lipoma
- Liponecrosis
- Fibrous tissue lesions
- Vascular origin
- Inflammatory origin
- Mastitis/abscess
- Tuberculosis and sarcoidosis
- Foreign body granuloma and siliconoma
- Lymph node origin
- Fatty tissue lesion
References
- ↑ 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.
- ↑ London SJ, Connolly JL, Schnitt SJ, Colditz GA (1992). "A prospective study of benign breast disease and the risk of breast cancer". JAMA. 267 (7): 941–4. PMID 1734106.
- ↑ Dupont WD, Page DL (1985). "Risk factors for breast cancer in women with proliferative breast disease". N Engl J Med. 312 (3): 146–51. doi:10.1056/NEJM198501173120303. PMID 3965932.
- ↑ Love SM, Gelman RS, Silen W (1982). "Sounding board. Fibrocystic "disease" of the breast--a nondisease?". N Engl J Med. 307 (16): 1010–4. doi:10.1056/NEJM198210143071611. PMID 7110289.
- ↑ Dupont WD, Page DL (1985). "Risk factors for breast cancer in women with proliferative breast disease". N Engl J Med. 312 (3): 146–51. doi:10.1056/NEJM198501173120303. PMID 3965932.
- ↑ Page DL, Dupont WD, Rogers LW, Landenberger M (1982). "Intraductal carcinoma of the breast: follow-up after biopsy only". Cancer. 49 (4): 751–8. PMID 6275978.
- ↑ Lanyi, M (2003). Mammography : diagnosis and pathological analysis. Berlin New York: Springer-Verlag. ISBN 9783540441137.
- ↑ Lai EC, Chan WC, Ma TK, Tang AP, Poon CS, Leong HT (2005). "The role of conservative treatment in idiopathic granulomatous mastitis". Breast J. 11 (6): 454–6. doi:10.1111/j.1075-122X.2005.00127.x. PMID 16297091.
- ↑ Kudva YC, Reynolds C, O'Brien T, Powell C, Oberg AL, Crotty TB (2002). ""Diabetic mastopathy," or sclerosing lymphocytic lobulitis, is strongly associated with type 1 diabetes". Diabetes Care. 25 (1): 121–6. PMID 11772912.