| Duct Hyperplasia with Atypia
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Etiology
•Secondary to an irregular response by breast tissue to hormonal stimuli
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Pathogenesis
• May be due to relative or absolute excess of estrogen, decrease in progesterone, or abnormal response to either hormone by breast tissue,
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Epidemiology
• Reproductive age women
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General Gross Description
• May be associated with microcalcifications within the lumens
• Gross findings may be of fibrocystic change
•Examples:
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General Microscopic Description
• Ducts exhibit more than the usual two layer epithelium (inner cuboidal to columnar cells; outer layer of myoepithelium)
• Either part or all of up to two ducts in one location (or a focus less than 2 mm in diameter) contain cells with all the cytologic and histologic features of duct carcinoma in situ
• Features include loss of polarity to lumen, round "punched-out" lumens, and homogeneity of cells
• Cells may show enlarged, round to oval nuclei and nucleoli
•Examples:
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Clinical Correlation
• Found either by mammography or incidentally
• Increased risk of developing breast carcinoma 4-5x
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References
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 1093-1097.
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| Duct Hyperplasia with Atypia
| | Synopsis by: Melinda Sanders M.D. (T04000M72175)[304]
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