36-year-old female suffered from mastodynia. In addition, she experienced cycle-dependent hardening of the breast. A mammography revealed presence of calcifications in ducts. The affected segment was excised.
- Breast parenchyma with pronounced fibrosis of the stroma and only scant presence of fatty tissue.
- Collagen fibers are mostly coarse, contrasting the delicate fibrous tissue surrounding normal lobules.
- Cystic dilatation of ducts. Cells lining dilated ducts show extensive apocrine metaplasia. The latter is characterized by cells exhibiting an abundant granular acidophilic cytoplasm and characteristic ‘apocrine snouts’. Within these foci formation of papillae is observed corresponding to papillary apocrine metaplasia.
- Focal proliferation of acini with perseveration of the epithelial and myoepithelial layer (adenosis).
- In this tissue section calcification is not present.
The presence of cysts, apocrine metaplasia and fibrosis is summarized under the term ‘fibrocystic change’, a non-proliferative breast lesion. In contrast, sclerosing adenosis, together with epithelial hyperplasia and complex sclerosing lesion (radial scar) represent proliferative breast diseases without atypia.