Benign Breast Pathology

Abstract

The most common cancer in women in the Western Hemisphere is breast carcinoma. It attracts a lot of attention from the public, and the population has become more aware of breast cancer through patient activism related to survivorship and improving research. Nevertheless, benign diseases of the breast are much more frequent and can cause symptoms and findings that are cause of much anxiety because of their overlapping features with their malignant counterparts. For example, a distortion identified radiologically can correspond to a radial scar as well as an invasive carcinoma. On the other hand, a well-circumscribed, lobulated mass is usually characteristic of a fibroadenoma, with a malignant neoplasm sometimes presenting with similar characteristics. Therefore, it is important to be familiar with the entities belonging to the benign breast diseases, in order to avoid unnecessary stress on patients and potential overtreatment. The incidence of benign lesions starts to increase during the second decade of life and peaks in the fourth and fifth decades. Although not universally accepted, two classifications for benign breast lesions have been proposed, one pathological, depicted in Table 34.1, and the other clinical, depicted in Table 34.2 (Love et al., N Engl J Med 307:1010–1014, 1982). This chapter provides a review of the spectrum of benign breast diseases while emphasizing potential diagnostic pitfalls and their features that overlap with malignant lesions.