benign epithelial lesions

• The vast majority of the lesions that occur in the breast are
benign
• The term “benign breast diseases” encompasses a
heterogeneous group of lesions that may present a wide
range of symptoms or may be detected as incidental
microscopic findings.
• Their major clinical significance is their relationship to the
subsequent risk of developing breast cancer.
 types of benign epithelial lesions

• Nonproliferative disease is not associated with an increased risk

of breastcancer

• Proliferative disease without atypia encompasses polyclonal hyperplasias

that are associated with a slightly increased risk of breast cancer.

• Proliferative disease with atypia includes monoclonal “precancers” that

are associated with a modest increase in the risk of breast cancer in
both breasts; overall, 13% to 17% of women with these lesions
develop breastcancer.
 Nonproliferative disease

consists of three major morphologic changes:

1. cysts
2. fibrosis
3. adenosis.

• . It is termed “nonproliferative” because the lesions contain single layers of epithelial

cells.

• The most common nonproliferative breast lesions are breast cysts.

• When cysts rupture, chronic inflammation and fibrosis, may produce palpable nodularity
of the breast (so-called “fibrocystic changes”).
fibrocystic changes
 Proliferative breast disease without atypia

• Proliferative breast disease without atypia is associated with a

greater breast cancer risk.

• It’s a group of non-cancerous, or benign conditions marked by an

increase in growth in certain cells in the breast.

• Proliferative disease without atypia includes :

1. epithelial hyperplasia
2. sclerosing adenosis
3. papilloma.
 Proliferative disease with atypia

includes atypical lobular hyperplasia (ALH) and atypical ductal

hyperplasia (ADH)

• resembles carcinoma in situ - but lacks sufficient qualitative

or quantitative features for diagnosis as carcinoma
Atypical lobular hyperplasia

• Atypical lobular hyperplasia occurs in the epithelial cells

lining the milk lobes.
• Some of these cells are irregular in shape and size, and thus
they are called atypical.
• Usually, a lobe is lined with one even layer of uniformly
shaped cells, but in ALH there may be several layers of cells.

Signs and Symptoms

Atypical lobular hyperplasia doesn't cause any notable

symptoms.
It is usually found on a routine screening mammogram.
In a few cases, atypical lobular hyperplasia may cause breast
pain.