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Tumors of the Breast

 

Breast Tumors can be from any component of breast tissue

A.  Stromal Tumors

1.       Fibroadenoma

2.       Phyllodes tumors

3.       Sarcoma 

 

Fibroadenoma

Phyllodes tumor  (Cystosarcoma Phyllodes)

Age presentation

younger than average age

Presents after 6th decade

Histology

·       New growth of stromal (clonal) and epithelial (polyclonal) elements

·       There is more stromal growth compared to ductal growth

· Intralobular stroma overgrowth that is covered by epithelium.

a.       Stromal cellularity mitosis

b.       Nuclear pleomorphisms

c.       Infiltrative boarders

Gross and Clinical presentation

·       Presents as sharply circumscribed, firm white, free mobile nodule

·        varying size.

·       Common site at the upper outer quadrant

· Can grow to be very large and bulbous like (looks like cauliflower)

· “fleshy appearance”

· Must be surgically removed

 

Benign vs malignant

Benign- NOT pre-cancerous

 

 

 

 

 

 

Benign- stroma is very cellular with some mitotic activity.

Borderline – stroma very inclusive

Malignant – has atypical cells, very large pleomorphic cells with lots of mitoses. Can take up other types of tissues like rhabdomyosarcoma.

phyllodes tumor
 

 
 

Sarcomas

1.       Tumors of extrinsic CT that present as bulky palpable masses

  1. Angiosarcoma - vasculature
  2. Leiomyosarcoma- smooth muscle
  3. Rhabdomyosarcoma – skeletal muscle
  4. liposarcoma- fat
  5. osteosarcoma - bone
  6. Phyllodes Tumor with sarcomatous elements
 


Epithelial tumors of the breast

  1. large duct papilloma

·         solitary lesion in large lactiferous ducts

·         clinically presents with

1.       bloody nipple discharge

2.       palpable mass near the nipple or areola

·         benign growth < 1cm à NO Carcinoma risk

·         composed of branching papillae with 2 cell layers

·         Histo: papilloma has a central fibro-vascular core surrounded by epithelial cells


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