Título del libro: Benign Disease Of The Breast: Diagnosis And Treatment
Título del capítulo: Proliferative stromal lesions
HERIBERTO MEDINA FRANCO;
Autores externos:
Idioma:
Inglés
Año de publicación:
2014
Resumen:
Proliferative stromal lesions include Diabetic fibrous mastopathy (DFM), Pseudoangiomatous stromal hyperplasia (PASH), and Complex sclerosing lesion (CSL) or Radial scar (RS). The main interest in these lesions is that they are commonly diagnosed as malignant breast lesions. DFM is a fibrous fibroinflammatory lesion that represents <1% of benign breast lesions. It occurs predominantly in premenopausal women with long-standing insulin-dependent Diabetes mellitus (DM), although it has also been observed in patients with type 2 diabetes. Clinical findings included single or multiple ill-defined, nontender, palpable, firm-to-hard masses in one or both breasts that raise suspicion of carcinoma. Microscopically, they are characterized by keloid fibrosis and variable periductal, perilobular, or perivascular lymphocytic infiltration that consists primarily of B cells. DM has not been linked with subsequent development of breast carcinoma or stromal neoplasia. If core biopsy is sufficient for diagnosis, a surgical excision can be avoided, because there are reports that surgery may exacerbate the condition. PASH is an even more uncommon lesion with approximately 300 cases described in the literature. It may present in a broad clinicopathologic spectrum ranging from an incidental histological finding to a clinically palpable breast mass, typically unilateral. On histological examination, the typical lesion is composed of complex anastomosing, slit-like empty spaces in a dense fibrous stroma. Core needle biopsy is warranted in suspicious cases to exclude malignancy. The treatment of PASH depends on its clinical presentation. No additional specific treatment is required if PASH is an incidental finding in specimens excised for other lesions. An excision with adequate but close margins is the recommended treatment for tumorous PASH; the lesion is not considered a premalignant lesion or a risk factor for malignancy. RS is a rare benign breast lesion of unknown etiology commonly identified by screening mammography. RS are by definition <1 cm and CSL, which are considered part of the same disease continuum, are described as their larger counterpart (>1 cm). The incidence of this condition has increased significantly due to the implementation of national breast cancer screening programs and is considered to be from 0.03-0.09%. These lesions are usually nonpalpable and have radiological and gross pathological characteristics that mimic breast carcinoma. Classical findings of an RS on mammograms include a stellate lesion with the presence of a radiolucent center with long, fine radiodense spicules, which create a "black star" appearance. Currently, diagnostic procedures are unreliable and due to the inherent risk of RS for underlying malignancy, the safest and most recommended approach for treatment of a suspicious stellate lesion is surgical excision. © 2014 by Nova Science Publishers, Inc. All rights reserved.
Entidades citadas de la UNAM:
ISBN:
9781633216495
Editorial:
Nova Science Publishers, Inc. Nombre de la publicación:
Proliferative stromal lesions
Página inicial:
109
Página final:
128
Tipo de producto:
Capítulo de un Libro
