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Breast-nonmalignant
Benign tumors / changes
Lactating adenoma of breast
Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)
Revised: 8 October 2012, last major update April 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Well circumscribed mass, arising during or shortly after pregnancy, composed of cuboidal cells with actively secreting, closely packed glands
Terminology
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Epidemiology
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● Usually during or shortly after pregnancy
● Most prevalent breast lesion in pregnant women and during post-partum period (puerperium)
Sites
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● May also develop in ectopic breast tissue in axilla, chest or vulva (along “milk line”)
Etiology
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● May actually be a coalescence of hyperplastic lobules, not a true adenoma
● May have common origin with tubular adenoma (Hum Pathol 1985;16:707)
Clinical features
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● May infarct or spontaneously involute
Prognostic factors
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Case reports
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● 21 year old pregnant woman with infarcted tumor (HCP Live 2007 November 20)
● 31 year old pregnant woman with infarcted tumor presenting as rapidly enlarging breast mass (AJR Am J Roentgenol 1999;173:933)
● 36 year old pregnant woman with coexisting invasive ductal carcinoma (J Clin Path 2005;58:87)
Treatment
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Clinical images
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Gross description (Macroscopy)
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● Well circumscribed, lobulated, solitary or multiple, gray-tan cut surface, frequent necrosis/infarction
Micro description (Histopathology)
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● Cuboidal cells with actively secreting, closely packed glands
● Resembles pregnancy-like (pseudolactational) changes
● Resembles fibroadenoma or tubular adenoma with lactational change microscopically
Micro images
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Lactating adenoma
Infarcted lactating adenoma
A: edge of infarction
B: hemosiderin laden macrophages
C: peripheral fibrosis
D: viable tumor
E: capsule
Drawings
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Virtual Slides
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Videos
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Cytology description
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● Cellular with epithelial cells scattered and in small groups
● Cells have foamy to finely vacuolated cytoplasm, uniform nuclei with fine chromatin and prominent nucleoli
● Background has abundant foamy material (Acta Cytol 1990;34:21, Indian J Pathol Microbiol 2001;44:445)
Cytology images
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Increased lobular size
Cytoplasmic vacuoles and background foamy material
Positive stains
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Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● Delayed involution of lactation: not circumscribed, hyperplastic and involuting lobules, neutrophils, macrophages and lymphocytes (J Med Case Reports 2008 Oct 13;2:327)
Additional references
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End of Breast-nonmalignant > Benign tumors / changes > Lactating adenoma
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