Slide of the Week: Mammary Gland Biopsy, August 22th, 2011

A 38 year old female (para 3, gravida 3), complains of persistent bilateral mammary gland pain associated with a “lumpy” feeling when she does a self- examination.  She carries a family history of breast cancer in both her mother and older sister.  A biopsy revealed the following image.

Mammary Gland Biopsy

The most likely diagnosis is:

  1. Medullary carcinoma
  2. Lobular Carcinoma in situ
  3. Fibrocystic disease
  4. Ductal carcinoma in situ

 

 

 

Click here to see the whole slide image.

Click here for the comparative pathology.

Scroll below for answers.


 

 

 

 

 

 

 

 

 

Answer: 3, Fibrocystic disease.


 

Comment:

Fibrocystic Disease (Condition) is a hormonally associated benign mammary disorder affecting about 60% of women.  The hormonal changes during the menstrual cycle cause the mammary gland to feel swollen, painful and “lumpy”.  Following menopause the changes usually subside. However, in cases of PHTS  and history, there is an increased risk for mammary malignancy. The solid nests have irregular slits which are considered benign. The cysts are apocrine cysts.

 

References:

Miltenburg DM, Speights VO Jr. Benign breast disease. Obstet Gynecol Clin North Am. 2008 Jun;35(2):285-300, ix. Review. PubMed PMID: 18486842.

Santen RJ, Mansel R. Benign breast disorders. N Engl J Med. 2005 Jul 21;353(3):275-85. Review. PubMed PMID: 16034013.

Valea FA, Datz VL “Breast diseases: diagnosis and treatment of benign and malignant disease”  In: Katz VL, Lentz GM Lobo RA, Gershenson DM, Eds. Comprehensive Gynecology 5th Ed Philadelphia, Pa Mosby Elsevier, 2007, Chapt 15.

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