1/117. Erosive adenomatosis of the nipple in an eight-year-old girl. Erosive adenomatosis of the nipple (EAN) is a rare, benign neoplasm of breast lactiferous ducts. Peak incidence is in the fifth decade in women. Clinically, it may be mistaken for Paget's disease and, histologically, for adenocarcinoma. Some authors have proposed an association with breast carcinoma and fibrocystic breast changes. Erosive adenomatosis of the nipple is extremely rare in children. Treatment is usually local excision of the nipple. This is the first formal English language case report of EAN in the pediatric age group. It is important for dermatologists to be familiar with this entity to prevent unwarranted breast removal. ( info) |
2/117. Radial scar of the breast. Four cases of radial scar of the breast, primarily diagnosed as carcinoma are presented; the patients were found among 858 patients who were operated on at our breast Unit over the last 4 years. The lesion was revealed on routine mammographic examination in 4 of our patients, while in the fourth it was found by palpation. In two of our patients mammographic examination revealed architectural distortion, in one patient micro-calcifications and in the fourth patient a stellate lesion was found. In the last two patients the lesion was localized before surgery with a hook wire. diagnosis was established by histopathologic examination in all cases. The surgeon, the radiologist and the pathologist should be aware of this clinical entity which, in spite of its benign character, has the ability to simulate invasive carcinoma clinically, mammographically and histopathologically. ( info) |
3/117. Clinical assessment of a breast mass: a case study. The estimated 180,300 new cases of breast cancer that were diagnosed in the united states during 1998 represent only a small percentage of the breast masses discovered by women and their healthcare providers during the same year. Almost half of women who have regular menstrual cycles will experience a breast mass during their reproductive years; and from 50% to 90% of all women will encounter fibrocystic breast changes. Imaging (ultrasound and mammography) and manual palpation have been demonstrated to be the most useful methods of breast mass detection and evaluation. A woman's age and reproductive status are factors to be considered in the selection of a protocol for the clinical assessment of a breast mass. While a suspicious lesion warrants immediate physician referral, nurse practitioners have important roles to play in the identification, documentation, and appropriate follow-up of breast masses. ( info) |
4/117. Atypical medullary carcinoma of the breast with cartilaginous metaplasia in a patient with a BRCA1 germline mutation. We examined a 34-year-old premenopausal woman who had noticed a left-breast lump a month previously. She had no past history of malignancies but had a family history of breast and ovarian cancers. Her mother had suffered from ovarian cancer when aged 47 years and had died of the disease at age 52. The younger two of the patient's four aunts had developed breast cancer when they were 37 and 48 years old. A physical examination showed an ill-defined mass, 1.5 cm in diameter, located in the upper outer quadrant of the patient's left breast. mammography revealed diffuse microcalcification in both breasts but ultrasonography revealed an irregular tumorous lesion only in the left breast. Aspiration breast cytology revealed adenocarcinoma of the left breast. Modified radical mastectomy of the left breast and excision of a biopsy specimen from the right breast were carried out simultaneously. Histopathologically the left-breast tumor was an atypical medullary carcinoma with cartilaginous metaplasia, of histological grade 3, and the right-breast specimen showed fibrocystic changes with atypical ductal hyperplasia. Estrogen receptors were positive, but progesterone receptor was not detected on the tumor cells, which were immunopositive for nuclear p53 although c-erbB-2 overexpression was not observed. A nonsense germline mutation of the BRCA1 gene (exon5) was detected. The patient has been well since the operation (10 months). These findings may provide useful information about the carcinogenesis and biological behavior of BRCA1-associated breast cancers. ( info) |
5/117. Lobular carcinoma in situ in sclerosing adenosis. The initial presentation of breast malignancy as noninvasive carcinoma in an area of sclerosing adenosis is unusual. Especially, lobular carcinoma in situ in sclerosing adenosis sometimes can be a potential source of confusion with invasive lobular carcinoma. We report a case of lobular carcinoma in situ presenting in adenosis exhibiting patterns akin to invasive lobular carcinoma, thus leading to potential misdiagnosis. overall architecture of the lesion as seen at lower power and immunohistochemistry can be useful to distinguish between sclerosing adenosis with lobular carcinoma in situ and infiltrating lobular carcinoma. ( info) |
6/117. Liesegang rings in cytologic samples accompanied by calcium oxalate-like crystals. A report of three cases. BACKGROUND: The presence of Liesegang rings (LRs) in cytologic specimens is a morphologic curiosity. The exact mechanism of formation and composition of these peculiar rings is a mystery. Their morphologic resemblance to parasites is well recognized and illustrated. Their association with calcium oxalate-like crystals and their presence in a tubercular lymph node are described for the first time below. CASES: Giemsa-stained aspiration smears from an enlarged lymph node and two breast lumps showed purple rings of variable morphology resembling ova, larvae or adult parasites. Misdiagnosis of parasites was avoided by careful evaluation. In all three cases the LRs were associated with calcium oxalate-like crystals and were nonbirefringent. CONCLUSION: LRs can be mistaken for ova, larvae or adult parasites. awareness of their varied morphology is helpful in avoiding misinterpretation and overdiagnosis of parasitic lesions. The coexistence of LRs and crystals was an unusual finding in this study. ( info) |
7/117. Intracystic papillary carcinoma in the male breast. A case report. male breast cancer is a rare disease with an incidence between 0.5% and 2.4% of that in women. We report a case of intracystic papillary carcinoma of the breast in a 75-year-old Japanese man. The macroscopic features of the carcinoma could be accurately demonstrated by pneumocystography and ultrasonography preoperatively. ( info) |
8/117. epidermal cyst of the breast: detection in a screening programme. Two cases of epidermal cyst of the breast, a rare benign condition, were detected during a 3-year period in a mammographic screening programme, from 57,954 screening examinations. It is not uncommon for epidermal cysts to be initially misdiagnosed. The mammographic, ultrasound and histological features are presented. It is recommended that these lesions be resected because they possibly have malignant potential. ( info) |
| Sclerosing lobular hyperplasia is a uncommon benign fibroproliferative lesion of the breast similar to a fibroadenoma. It usually presents as a mass in the outer quadrant of the breast of younger women. The authors report an atypical case of sclerosing lobular hyperplasia that presented as bilateral breast masses in an elderly woman after a reduction mammaplasty. breast masses that develop after reduction are often a result of fat necrosis, internal scarring, or organizing hematomas. Those that do not resolve warrant open biopsy because they may represent malignant or benign neoplasms. ( info) |
10/117. Fibrous tumor of the breast in a postmenopausal woman receiving estrogen. Fibrous tumor of the breast is a rare, benign stromal proliferation with atrophy of the epithelial component. Almost all patients who develop fibrous tumors are premenopausal. An unusual example of fibrous tumor of the breast is reported in a 62-year-old postmenopausal woman. The mass, first noted 1 year previously, progressively enlarged over the year. The patient noted a history of taking exogenous estrogens for 10 years. Intense estrogen administration during the year of enlargement may be associated with accelerated growth of the tumor. In addition, positive nuclear staining for estrogen receptor antibodies in stromal cells was demonstrated by immunohistochemical methods. ( info) |