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Benign breast diseases

Benign breast diseases. Dr Maryam Tabatabaeian. Benign breast lesions. Non proliferative no risk for malignancy cysts,fcc without hyperplasia,epithalial calcifications,apocrine papillary changes, Proliferative without atypia 1/5-2 × risk

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Benign breast diseases

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  1. Benign breast diseases Dr Maryam Tabatabaeian

  2. Benign breast lesions • Non proliferative no risk for malignancy cysts,fcc without hyperplasia,epithalialcalcifications,apocrine papillary changes, • Proliferative without atypia 1/5-2× risk Ductalhyperplasia,papilloma,sclerosingadenosis,radialscar,fibroadenoma • Proliferative with atypia 3/7-5/3× risk ADH,ALH

  3. Fibroadenoma B3 Single or multiple(FH) Most masses in women<30yrs Size>3cm,age>35yrs,FH+,growth rate>30% in 3 months biposyor excision if patients is stressed Giant fibradenoma>5cm benign 17%regression without therapy Macrolobulation is normal microlobulation needs biopsy Complex fibradenoma surgery

  4. Cysts • Simple cyst B2 thin wall,single or multiple,clearcontent,size<3cm no risk ,routine follow up • Complicated cyst B3 thick wall<5mm,septation,internal echo,no flow in dopplersono 0/4% malignancy hematoma,absess,fatnecrosis,galactocele • Complex cyst B4 Thick wall>5mm,size>5cm,mass component,shadow absses,apocrinemetaplasia,oilcyst,fatnecrosis,malignancy 20-40% malignant

  5. Mass • <30 yrs mostly benign 75%fibroadenoma • >50 yrs half malignant • <30yrs sonogram • >35 yrs mammogram • BIRADS 3 without riskfactorfollow up • BIRADS 4 or B3 with risk factor biopsy • Biopsy CNB

  6. Mass • Mammogram 20% false negative 40- 50 yrs 10% false negative>50 yrs After a negative biopsy follow up each 6 months to 2 yrs is mandatory

  7. Thickening 2 dimentional lesion Mammogramm and sonogram and other complementary test as indicated 10-17% need biopsy 50% of biopsies are malignant no need to medical treatment

  8. Papilloma is benign but needs surgery because of nipple bleeding Papillomatosis : .5 papilloma in one segment no risk for malignancy

  9. ADH,ALH • Gail model for risk assesment • No OC or HRT • Flat epithelial hyperplasia exscision, less risk for malignansy

  10. hamartoma • Fibroadenolipoma malignant tranformationsugery

  11. Adenoma Pure epithelial component,tubular and lactating subtype No risk for malignancy Surgery in suspicious forms

  12. Granulomatous mastitis non TB granulomatosis Presents as mastitis or inflamation and mass Dx CNB Treatment :treatment of absses and then corticosteroids in refractore cases Surgery has malconvinient results and deformities cause to unnecessary mastectomies

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