Atypical ductal hyperplasia (ADH) is a histologically borderline lesion that has some, but not all the features of ductal carcinoma in situ (DCIS). Sometimes the distinction between ADH and DCIS is simply on the basis of the number of ducts involved.
Atypical ductal hyperplasia is a...
Atypical lobular hyperplasia (ALH) is a pre-malignant lesion of the breast which falls at the milder end of the spectrum of lobular neoplasia. It is therefore considered a part of borderline breast disease.
It is usually asymptomatic and mammographically occult and is in...
A breast abscess is a relatively rare but significant complication of mastitis that may occur during breastfeeding, particularly in primiparous women. The clinical context is a key to diagnosis as imaging appearances (particularly ultrasound) can mimic many other entities such as breast carcinom...
Amyloid deposition in the breast is predominantly of two forms
breast involvement in primary amyloidosis - commoner
in association with other conditions like multiple myeloma, plasmacytosis and rheumatoid arthritis and another in the localised form which is rarer.
Breast aneurysms are a rarely seen cause of a breast mass.
true aneurysm: occurs post trauma and is seen as a slowly enlarging pulsatile mass
false aneurysm / pseudoaneurysm: occurs in acute trauma, post percutaneous biopsy, due to spontaneous haemorrhage secondary to coagulo...
Breast cellulitis is an acute pyogenic inflammatory change involving the dermis and subcutaneous tissue. This can be secondary to any wound, surgery or radiation for breast carcinoma.
inflammatory changes such as oedema, swelling and redness of the involved breast
Breast haematoma can result from preceding direct trauma, surgery, biopsy (rare) or contusion and can be easily misinterpreted as other lesions such has breast malignancy if the correct clinical context is not taken into account. They can rarely occur spontaneously, especially in those with coag...
Breast hamartoma (also known as a fibroadenolipoma) is a benign breast lesion.
They typically occur in women older than 35 years of age.
While it can present as a painless soft lump, it may also present as unilateral breast enlargement without a palpable l...
Breast implant ruptures are a recognised complication of a breast implant. It can be intracapsular, when confined by the surrounding fibrous capsule, or extracapsular, when silicone freely extravasates.
After implantation of a silicone or saline breast implant, a fibrous capsule (sc...
Breast lipomas are a benign breast lesion and is classified as a BIRADS II lesion.
Lipomas are mostly asymptomatic and coincidentally discovered on routine mammography. Patients may present with a painless palpable breast lump which is soft and mobile. In these cases the ...
Breast lymphoma refers to involvement of the breast with lymphoma and may be primary or secondary.
Both primary and secondary breast lymphoma are rare accounting for ~ 0.5% (range 0.3-1.1%) of all breast malignancies.
Breast lymphoma may present either as a...
Breast sebaceous cyst, also sometimes known as an epidermal inclusion cyst or simply epidermoid cyst, is a benign breast lesion (BIRADS II).
For a general discussion of this entity outside the breast, please refer to epidermal inclusion cysts.
The two terms, breast sebaceous cys...
Breast varix is, as the name suggests, varices in the breast that are focally dilated veins in the breast.
If varices are seen bilaterally then a cause for central venous obstruction (superior vena cava syndrome) could be the underlying aetiology with the varices being a part of the...
Capsular contractures are a potential complication of a breast implant and refers to a tightening and hardening of the capsule that surrounds a breast implant. It is a condition that can distort the shape and cause pain in the augmented breast. It seems to be the commonest complication post-brea...
Serum carcinoembryonic antigen (CEA) is a cell-adhesive glycoprotein that was discovered in colorectal cancer in 1965, and is hence one of the oldest and most used tumour markers. Its name derives from its normal expression in fetoembryonic liver, gut and pancreas tissue.
Normal range of CEA is...
Cavernous venous malformation, also traditionally referred to as a cavernous haemangioma (despite it not being a tumour) or cavernomas, are non-neoplastic slow flow venous malformations found in many parts of the body.
Despite the ubiquity of use of the traditional terms cavernoma...
Columnar alteration with prominent apical snouts and secretions (CAPSS) is a pathological entity encountered when breast biopsies are done for investigation of punctate or amorphous calcifications. CAPSS involves the terminal ductal and lobular units (TDLU's).
It is sometimes classified under t...
A comedo-type ductal carcinoma in situ, also known as comedocarcinoma in situ is the high grade subtype of ductal carcinoma in situ (DCIS). It completely fills and dilates the ducts and lobules in TDLU with plugs of high grade tumour cells with central necrosis "comedonecrosis".
It is the mos...
Complex fibroadenoma is a sub type of fibroadenoma harbouring one or more of the following features:
papillary apocrine metaplasia
sclerosing adenosis and
cysts larger than 3 mm
Complex fibroadenomas tend to occur in older patients (median age, 47 ye...
Complicated breast cysts are one of the cystic breast lesions that show intracystic debris which may imitate a solid mass appearance. They should be carefully differentiated from a complex cyst and may require alternative management 3.
thin wall with or withou...
Diabetic mastopathy (DMP) is a condition characterised by the presence of a benign tumour like breast masses in women with long-standing type 1 or type 2 insulin-dependent diabetes. The condition has also been reported in men.
Diabetic mastopathy manifests clinically as a...
A ductal adenoma of the breast is a benign glandular tumour of the breast that usually fills and distends the ductal lumen.
They may occur in women of all ages, although the majority of patients are 60 years of age or greater 3.
Ductal adenomas usually pres...
Ductal carcinoma in situ (DCIS) refers to a breast carcinoma limited to the ducts with no extension beyond the basement membrane, as a result of which the disease has not infiltrated the parenchyma of the breast and the lymphatics and cannot therefore metastasise.
The detection of...
Extensive intraductal component (EIC) in breast imaging evaluation is the pathological description where an invasive ductal carcinoma has a prominent intraductal component within it or if there is intraductal carcinoma, DCIS is present within sections of normal adjacent tissue. It is sometimes c...
Fat necrosis within the breast is a pathological process that occurs when there is saponification of local fat. It is a benign inflammatory process and is becoming increasingly common with the greater use of breast conserving surgery and mammoplasty procedures.
Most at risk are mi...
Fibroadenoma is a common benign breast lesion and results from excess proliferation of connective tissue. Fibroadenomas characteristically contain both stromal and epithelial cells.
They usually occur in women between the ages of 10 and 40 years. It is the most common breast mass...
Fibrocystic change of the breast (also known as diffuse cystic mastopathy) is a benign alteration in the terminal ductal lobular unit of the breast with or without associated fibrosis. It is seen as a wide spectrum of altered morphology in the female breast from innocuous to those associated wit...
Fibromatosis of the breast (also known as an extra-abdominal desmoid tumour of the breast or mammary fibromatosis 4) is considered as a type of rare breast tumour. It is a non-metastasising benign but locally invasive stromal tumour 4. However, it can mimic more sinister types of breast cancer o...
Fibrosarcoma of the breast is a type of malignant stromal sarcoma that rarely occurs as a primary tumour within the breast.
A fibrosarcoma is composed of immature mesenchymal elements surrounded by a collagenous substance. It is a type of breast sarcoma with a predominant “herringbo...
Gel bleed is a phenomenon associated with silicone breast implants.
Gel bleed refers to microscopic diffusion of silicone gel through the breast implant elastomer shell. The implant shell, made of silicone, is a semipermeable membrane that allows for the egress or bleed of silicone n...
Giant fibroadenomas are fibroadenomas weighing more than 500 grams or measuring >5 cm in size 2. They are usually encountered in pregnant or lactating women.
Gigantomastia (or macromastia) is a term given when there is massive breast enlargement. It is often associated with pregnancy.
Gigantomastia is a very common condition characterised by proliferation of either breast fatty tissue or glandular tissue or both, resulting in rapid increase in breas...
A granular cell tumour (GCT) of the breast is an uncommon, usually benign tumour which is possibly of neural origin.
They tend to occur at a younger age than other types of breast cancer 4. The age range of presentation, however, can be very variable although they occur more commo...
Breast involvement in granulomatosis with polyangiitis is seen in patients with avid systemic manifestations.
Clinically they can mimic carcinoma as a palpable, tender mass.
Granulomatosis with polyangiitis (or formerly known as Wegeners granulomatosis) is a ...
Granulomatous mastitis is a very rare breast inflammatory disease of unknown origin that can clinically mimic carcinoma of the breast.
The condition generally manifests as a distinct, firm to hard mass that may involve any part of the breast. The subareolar regions may be...
Hereditary breast and ovarian cancer (HBOC) syndrome is caused by mutation to either BRCA1 or BRCA2 genes. These patients have an increased risk of breast cancer, ovarian cancer, pancreatic cancer and prostate cancer. However, these gene mutations are not the only cause of hereditary breast canc...
Infiltrating syringomatous adenoma of the nipple is a relatively rare, benign dermal neoplasm in the areola and nipple.
Syringomatous adenomas of the nipple usually present as unilateral 1 to 3 cm firm lesion in the subareolar or nipple region of the breast. Tenderness, i...
Inflammatory carcinomas of the breast also referred as inflammatory breast cancers, are a relatively uncommon but aggressive form of invasive breast carcinoma which has a characteristic clinical presentation and unique radiographic appearances.
Inflammatory carcinomas account f...
Intracystic carcinoma of the breast refers to a breast cancer located within a cyst.
They represent ~0.2-1.3% of all breast cancers.
Often they tend to represent papillary breast cancer 2:
intracystic papillary breast carcinoma (ICPC)
cystic degeneration of ductal c...
An intracystic papillary carcinoma of the breast is a type of papillary carcinoma of the breast. It accounts for a significant proportion of intracystic breast cancers.
As with papillary carcinomas in general, it tends to occur in postmenopausal women.
Intraductal papillomas, or more specifically solitary intraductal papillomas of the breast, are benign breast lesions. Papillomas are the most common intraductal mass lesions of the breast.
Typically present in women in their late reproductive or postmenopausal years (with an aver...
Invasive ductal carcinoma is a subset of ductal carcinoma. It is an infiltrating, malignant and abnormal proliferation of neoplastic cells in the breast tissues. It is the most frequently seen breast malignancy.
Peak age of presentation is about 50 to 60 years.
Infiltrating or invasive lobular carcinoma (ILC) of the breast is the second most common type of invasive breast cancer after invasive ductal carcinoma (IDC) "not otherwise specified" (NOS).
They represent 5-10% of all breast cancer. The mean age at presentation may be higher than...
A juvenile fibroadenoma of the breast is a term given to a fibroadenoma presenting in children or adolescents. These may account for ~0.5-2% of all fibroadenomas, and are rapidly growing masses that cause asymmetry of the breast, distortion of the overlying skin, and stretching of the nipple.
Juvenile papillomatosis (JP) of the breast is a relatively common benign localised proliferative lesion in the breast.
As the name implies, it is mainly seen in young women (mean age ~19-23 years 4,6) and is unusual in women over 30 years old.
Lactating adenomas are a benign breast tumour that typically occur in the peri-partum period, and are one of the most prevalent breast lesions during puerperium 4.
Lactating adenomas commonly present as painless breast masses late in pregnancy or in the postpartum period....
Lobular breast carcinoma is a subtype of breast cancer can range from lobular carcinoma in situ (LCIS) to invasive lobular carcinoma.
Multicentricity and bilaterality tend to be quite common with lobular breast carcinomas.
Lobular carcinoma in situ (LCIS) represents the next step up from atypical lobular hyperplasia (ALH) along the malignant spectrum of lobular breast carcinoma.
LCIS occurs predominantly in premenopausal women with a mean age of 45 years old, approximately 10-15 years younger than t...
Lymphocytic mastopathy also known as sclerosing lymphocytic lobulitis is a rare, benign inflammatory disease of the breast that can mimic breast cancer. Diabetic mastopathy is a closely related entity although it is sometimes used synonymously in the literature.
Male breast cancer is exceptionally rare and only accounts for less than 0.25% of male malignancies and ~0.5-1% of all breast cancer (both genders).
The average age of diagnosis of male breast cancer is 60-70 years, which is later than female breast cancer.
Malignant phyllodes tumours of the breast account for up to a quarter of the phyllodes tumours.
Please, refer to the main article on phyllodes tumours for a general discussion.
It is generally thought that it is the stromal component that becomes malignant 4. This may account for t...
Mammary duct ectasia is characterised by chronic inflammatory and fibrotic changes leading to clogging of debris within the duct. It is of primary importance because of its features mimicking to that of malignancy.
Some publications use this term synonymously with periductal mastit...
Medullary carcinoma of the breast (MCB) is an uncommon subtype of breast cancer and accounts for ~5% 1,4 of all breast cancers.
They tend to occur more frequently in younger women than other breast cancer types 7. The mean age of presentation varies from 46-54 years but in 10% of ...
Metaplastic breast carcinoma (MBC), also known as spindle cell carcinoma of the breast (SpCC), is a rare form of primary breast malignancy and accounts < 5% of breast carcinomas.
These are scarce lesions, rarely seen in general radiology practice. The lesions usually present as mass in postmeno...
Microglandular adenosis (MGA) of the breast is a pathological subtype of mammary adenosis. It is benign breast condition although can mimic a breast cancer (particularly tubular breast carcinoma 3,5) both clinically, radiology and pathologically.
It is considered the only benign brea...
Mondor disease is a rare benign breast condition characterised by thrombophlebitis of the subcutaneous veins of the breast and anterior chest wall.
Although Mondor disease is rarely reported in the literature, this is likely in part due to lack of awareness of the entity. It tends...
Mucinous carcinoma of the breast, also known as colloid breast carcinoma, is a subtype of invasive ductal carcinoma (IDC). They account for about ~ 2% (range 1-7% 4) of breast cancers.
It tends to occur in older women where a prevalence of as much as 7% is found among women 75 ye...
Nevoid hyperkeratosis of the nipple and the areola (NHNA) is a rare, idiopathic and benign dermatological condition.
Most often seen in females of reproductive age, especially during 2nd and 3rd decades of life. Less than 70 cases have been reported till now.
Nipple adenoma is a rare, benign breast lesion which often mimics a malignancy
Patient presents with bloody discharge from an ulcerated and painful nipple in one breast. There is itching associated with this lesion. Symptoms may show variation with the menstrual cycle. T...
Non-comedo type ductal carcinoma in situ is a subgroup of ductal carcinoma in situ (DCIS). This group comprises of relatively less aggressive types with low nuclear grade. It can have has multiple patterns which are often mixed:
cribriform type non-comedo DCIS
micropapillary type non-comedo D...
Oil cysts in breast imaging refer to benign breast lesions where an area of focal fat necrosis becomes walled off by fibrous tissue.
Occurs across all age and ethnic groups with a female predilection. Usually associated with blunt trauma if present in males.
Paget disease of the breast, which is also known as Paget disease of the nipple, has traditionally been described as a form of breast malignancy characterised by infiltration of the nipple epidermis by malignant cells. Although most cases have underlying focus or foci of in situ or invasive carc...
Papillary carcinoma of the breast is a rare ductal breast malignancy.
They are thought to account for 1-2% of breast carcinomas 2. They typically present in postmenopausal patients with the mean age at being ~63-67 years.
A papillary carcinoma may manifest ...
Phyllodes tumour, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumour of the breast which has some resemblance to a fibroadenoma. It is typically a large, fast growing mass that forms from the periductal stroma of the breast.
Phyllodes tumours account for less t...
Plasma cell mastitis is a benign breast condition which represents calcification of inspissated secretions in or immediately adjacent to ectatic benign ducts.
It is typically seen in older women (e.g. > 60 years of age).
It is thought to represent aseptic inflammation...
Primary osteosarcoma of the breast is an uncommon breast malignancy and is a sub type extraskeletal osteosarcoma.
While it can present in a wide are group, the peak age at presentation is around the 6th decade 7.
The presence of bone in breast lesions is not diagnosti...
Pseudoangiomatous stromal hyperplasia (PASH) is a benign, relatively uncommon form of stromal (mesenchymal) overgrowth within breast tissue that derives from a possible hormonal aetiology.
Typically affects women of reproductive age. It rarely affects males.
Pseudogynaecomastia refers to breast enlargement in men primarily due to fatty tissue but with no associated glandular or stromal tissue.
Puerperal mastitis refers to mastitis occurring during pregnancy and lactation.
It occurs most often during breast feeding and is rarely encountered during pregnancy.
The source of infection is the nursing infants nose and throat; the organisms being Staphylococcus aur...
Radial scar, or complex sclerosing lesion, is a rosette-like proliferative breast lesion. It is not related to surgical scarring. Some authors, however, reserve the latter term to lesions over 1 cm 5.
It is an idiopathic process with sclerosing ductal hyperplasia.
Its significance is that it...
The term recurrent breast cancer in medical imaging is given to recurrence of malignancy within the same breast at or close to the resection bed more than two years following surgical excision.
The rate of local recurrence may be as high as 19% in 10 years. The maximum for recurre...
Scirrhous carcinoma of the breast is a pathological sub type of breast cancer. It is a sub type of invasive ductal carcinoma not otherwise specified and present as a hard lump. The proportion of pathologic lymph node metastasis among scirrhous carcinomas is significantly higher than that among c...
Sclerosing adenosis (SA) is a benign (non-cancerous) proliferative condition of the terminal duct lobular units characterised by an increased number of the acini and their glands. It is sometimes placed under the category of borderline breast disease.
In women with sclerosing adenosis, multiple...
Sclerosing lobular hyperplasia (SLH) of the breast, also known as fibro-adenomatoid mastopathy, is an uncommon benign proliferative breast lesion.
It tends to occur more often in adolescent and young adult patients (peak age in the thirties). In the United States, there may be a g...
Sclerosing papillomas of the breast are a sub type of intraductal papilloma of breast. It is termed when a papillary lesion form well-defined solid masses with a dominant sclerosed architecture 2. It is usually a histological diagnosis and usually cannot be differentiated from a non sclerosing p...
Seromas are collections of serous fluid that usually occur as a complication of surgery, but can also be seen post-trauma. It is most commonly associated with post-breast surgery, where a potential space is left.
Seromas are distinct from a haematoma as it contains almost no red bl...
Breast cysts are a relatively common cause of a breast lump in perimenopausal women, and usually causing wage pain or discomfort and slightly tender on palpation. They are a benign (BIRADS II) entity.
Breast cysts are caused by blockage of the terminal acini with resultant dilatation...
Skin calcifications in the breast usually form in dermal sweat glands after low grade folliculitis and inspissation of sebaceous material. Calcifications may also form in moles and other skin lesions. Often, these calcifications are in groups as they extend into small glands in the skin. Occasi...
Subareolar breast abscess are relatively uncommon and tend to occur mostly in young women.
Mastalgia, signs of inflammation, lump formation in the subareolar region and nipple discharge. In chronic cases fistula formation and nipple deformity may be seen.
Suture calcification in breast can be seen after a lumpectomy and/or radiation therapy. It is theorized that tissue damage from radiation therapy delays the resorption of the suture. The residual suture material is thought to act as a nidus for calcification.
Synchronous breast cancers are two breast cancers that occur in either breast at the same time.
Up to 10% of all breast cancers may be synchronous (particularly found with the use of breast MRI). The occurrence of bilaterality is greatest with invasive lobular carcinoma.
Triple receptor-negative (TRN) breast cancer refers to the lack of hormone receptors and HER2/neu staining:
oestrogen receptor negative
progesterone receptor negative
human epidermal growth factor receptor 2 (HER2) negative
It is more likely to affect younger people and races s...
Tuberous breasts are congenital deformities of breast. They are defined by reduced parenchymal volume and herniation of breast tissue through the nipple-areola complex.
The exact incidence is not clear. However, it is a common cause of patients presenting with breast asymmetry. Pr...
Tubular adenomas (TA) of the breast, also known as pure adenoma of the breast, are a rare benign breast lesion. It is a type of adenomatous breast lesion.
They are typically found in young women and are usually palpated by the patient or her physician.
On gross patholo...
Tubular carcinoma of the breast is a subtype of invasive ductal carcinoma (IDC).
These account for ~1% of breast cancers. The peak age at presentation may be comparatively younger than with other types of breast cancer 7.
The vast majority of tubular carci...
A tubulolobular carcinoma (TLC) of the breast is considered a subtype of breast cancer that features of both invasive lobular carcinoma and tubular carcinoma of the breast. It therefore exhibits features of both ductal and lobular differentiation. Multifocality, muticentricity and percentage of ...
Vascular calcifications in the breast are calcifications associated with blood vessels.
They are most often seen in post menopausal women with arteriosclerotic heart disease.
Results due to calcified atherosclerotic plaques in the arterial walls.