Mammary adenosis: Difference between revisions
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== Diagnosis == | == Diagnosis == | ||
=== Symptoms === | === Symptoms === | ||
*Symptoms of mammary adenosis may include the following: | *Symptoms of mammary adenosis may include the following: | ||
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=== Laboratory Findings === | === Laboratory Findings === | ||
*There are no specific laboratory findings associated with | *There are no specific laboratory findings associated with mammary adenosis. | ||
===Imaging Findings=== | ===Imaging Findings=== | ||
* | *Mammography is the imaging modality of choice for mammary adenosis. | ||
*On mammograms, mammary adenosis is characterized by bilateral appearance of mammary adenosis, and often with diffuse and scattered microcalcifications, asymmetric density with microcalcifications, a solitary cluster of microcalcifications, or as a non-calcified mass. | |||
*On mammography, mammary adenosis may consist of architectural distortion, amorphous microcalcifications, or both. At times a mass lesion or asymmetrical density may be present. It can be therefore very difficult to mammographically distinguish from an infiltrating carcinoma. | |||
*On | *When the rarer, unusual presentations occur, it is recommended to have the findings verified with a biopsy. When it presents as a mass it is referred to as either ‘nodular adenosis’ or ‘adenosis tumor’, but it is not a tumor and is not cancerous. | ||
* | |||
=== Other Diagnostic Studies === | === Other Diagnostic Studies === | ||
* | *Mammary adenosis may also be diagnosed using biopsy. | ||
*Findings on | *Findings on biopsy includes a proliferation of elongated, obliterated, or distorted glands and tubules, in addition to hardening of surrounding collagen and stroma tissue. The condition is sometimes called fibrosing adenosis, or adenofibrosis, and tends to arise from problems with the terminal duct lobular unit. (TDLU) | ||
On mammography, sclerosing adenosis may consist of architectural distortion, amorphous microcalcifications (which can be present in 40-55% of cases 5,6), or both. At times a mass lesion or asymmetrical density may be present. It can be therefore very difficult to mammographically distinguish from an infiltrating carcinoma. | |||
When these rarer, unusual presentations occur, it is best to have the findings verified with a biopsy. When it presents as a mass it is referred to as either ‘nodular adenosis’ or ‘adenosis tumor’, but it is not a tumor and is not cancerous. | |||
== Treatment == | == Treatment == | ||
=== Medical Therapy === | === Medical Therapy === | ||
Revision as of 20:19, 27 April 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Your Name
Synonyms and keywords: Synonym 1; Synonym 2; Synonym 3
Overview
Historical Perspective
- [Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
- In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
- In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].
Classification
- [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
- [group1]
- [group2]
- [group3]
- Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
Pathophysiology
- On microscopic histopathological analysis, slit-like, smaller acini that are in lobular arrangements and fibrosis which surround the acini are characteristic findings of mammary adenosis.
- In mammary adenosis enlarged acini become slightly distorted by surrounded stromal fibrosis. However, adenosis and sclerosing adenosis retain the lobular architecture, but it becomes exaggerated and distorted. Fibrosis can mimic a desmoplastic reaction.
Immunohistochemistry
- Fibrosis is pink on H&E stain.
Associated Conditions
- Mammary adenosis can be seen as a component of other proliferative lesions, such as:
- Intraductal and/or sclerosing papilloma and complex sclerosing lesion, and can be present within fibroadenomas
- Invasive and in situ cancers
Causes
- [Disease name] may be caused by either [cause1], [cause2], or [cause3].
- [Disease name] is caused by a mutation in the [gene1], [gene2], or [gene3] gene[s].
- There are no established causes for [disease name].
Differentiating [disease name] from other Diseases
- [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
- [Differential dx1]
- [Differential dx2]
- [Differential dx3]
Epidemiology and Demographics
Mammary adenosis accounts for approximately 12% of breast biopsy specimens.
Age
- Mammary adenosis is more commonly observed among patients aged 30-45 years.
Gender
- Females are more commonly affected with mammary adenosis than males.
Race
- There is no racial predilection for mammary adenosis.
Risk Factors
- Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
Natural History, Complications and Prognosis
- The majority of patients with [disease name] remain asymptomatic for [duration/years].
- Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
- If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].
Diagnosis
Symptoms
- Symptoms of mammary adenosis may include the following:
- Recurring pain that tends to be linked to the menstrual cycle.
Physical Examination
- Physical examination may be remarkable for:
- Multiple small, firm, tender lumps.
- Mammary adenosis is not palpable in approximately 80% of the cases, however in some cases, it might cause skin retraction.
- A lump may be felt and may be painful.
Laboratory Findings
- There are no specific laboratory findings associated with mammary adenosis.
Imaging Findings
- Mammography is the imaging modality of choice for mammary adenosis.
- On mammograms, mammary adenosis is characterized by bilateral appearance of mammary adenosis, and often with diffuse and scattered microcalcifications, asymmetric density with microcalcifications, a solitary cluster of microcalcifications, or as a non-calcified mass.
- On mammography, mammary adenosis may consist of architectural distortion, amorphous microcalcifications, or both. At times a mass lesion or asymmetrical density may be present. It can be therefore very difficult to mammographically distinguish from an infiltrating carcinoma.
- When the rarer, unusual presentations occur, it is recommended to have the findings verified with a biopsy. When it presents as a mass it is referred to as either ‘nodular adenosis’ or ‘adenosis tumor’, but it is not a tumor and is not cancerous.
Other Diagnostic Studies
- Mammary adenosis may also be diagnosed using biopsy.
- Findings on biopsy includes a proliferation of elongated, obliterated, or distorted glands and tubules, in addition to hardening of surrounding collagen and stroma tissue. The condition is sometimes called fibrosing adenosis, or adenofibrosis, and tends to arise from problems with the terminal duct lobular unit. (TDLU)
On mammography, sclerosing adenosis may consist of architectural distortion, amorphous microcalcifications (which can be present in 40-55% of cases 5,6), or both. At times a mass lesion or asymmetrical density may be present. It can be therefore very difficult to mammographically distinguish from an infiltrating carcinoma. When these rarer, unusual presentations occur, it is best to have the findings verified with a biopsy. When it presents as a mass it is referred to as either ‘nodular adenosis’ or ‘adenosis tumor’, but it is not a tumor and is not cancerous.
Treatment
Medical Therapy
- There is no treatment for [disease name]; the mainstay of therapy is supportive care.
- The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
Surgery
- Surgery is the mainstay of therapy for [disease name].
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
- [Surgical procedure] can only be performed for patients with [disease stage] [disease name].
Prevention
- There are no primary preventive measures available for [disease name].
- Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].