Mammary adenosis: Difference between revisions
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==Overview== | ==Overview== | ||
Sclerosing adenosis | Sclerosing adenosis is a benign proliferative condition of the terminal duct lobular units characterised by an increased number of the acini and their glands. | ||
In women with mammary adenosis, multiple small, firm, tender lumps; fibrous tissue; and sometimes small cysts form in the breast. Mammary adenosis is a proliferative breast lesion in which various elements have become hardened, damaged, or otherwise distorted. It is a lobular lesion with increased fibrous tissue and interspersed glandular cells.<ref name="radio">mammary adenosis. Radiopedia(2015) http://radiopaedia.org/articles/sclerosing-adenosis-of-the-breast Accessed on April 25, 2016</ref> | |||
In women with | |||
==Historical Perspective== | ==Historical Perspective== | ||
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:*Multiple small, firm, tender lumps. | :*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. | :*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. | :*A palpable lump may be felt and may be painful. | ||
=== Laboratory Findings === | === Laboratory Findings === | ||
Revision as of 13:22, 28 April 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Synonyms and keywords: Adenofibrosis; Fibrosing adenosis; Adenosis tumor; Nodular adenosis; Sclerosing adenosis of breast; SA; Sclerosing adenosis
Overview
Sclerosing adenosis is a benign proliferative condition of the terminal duct lobular units characterised by an increased number of the acini and their glands. In women with mammary adenosis, multiple small, firm, tender lumps; fibrous tissue; and sometimes small cysts form in the breast. Mammary adenosis is a proliferative breast lesion in which various elements have become hardened, damaged, or otherwise distorted. It is a lobular lesion with increased fibrous tissue and interspersed glandular cells.[1]
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
- Mammary adenoss may be classified into two 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.[2]
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 Mammary adenosis from other Diseases
- Mammary adenosis must be differentiated from other diseases, such as:[2]
- Low-grade ductal carcinoma
- Tubular adenoma of the breast
- Adenomyoepithelioma
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 palpable 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 mammary adenosis presents as a mass it is referred to as either ‘adenosis tumor’ or ‘nodular adenosis’, although it is not a tumor and is not cancerous.[1]
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 stromal tissue.
- In majority of cases, mammary adenosis is detected during routine mammograms or following breast surgery. Usually, a biopsy is required to confirm the diagnosis, because the condition is otherwise difficult to distinguish from breast cancer.
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].
References
- ↑ 1.0 1.1 mammary adenosis. Radiopedia(2015) http://radiopaedia.org/articles/sclerosing-adenosis-of-the-breast Accessed on April 25, 2016
- ↑ 2.0 2.1 sclerosing adenosis. Libre pathology(2015) https://librepathology.org/w/index.php?title=Breast_pathology&redirect=no#Sclerosing_adenosis Accessed on April 26, 2016