SITUATIONAL ANALYSIS

BREAST PATHOLOGY

by

MARY ANN O. CABRERA, M.D.

EMMANUEL R. DE LA FUENTE, M.D.
 Objectives :

3. Recognize non-neoplastic and neoplastic diseases of the

female and male breast

5. Correlate clinical manifestations of breast diseases with the

pathologic findings

7. Discuss the etiopathogenesis of common breast disease

9. Discuss pathologic factors that affect prognosis and

response to modalities of treatment
 SITUATION 1

A 22-year-old woman has given birth to a healthy

term baby following an uncomplicated pregnancy.
She has been breast feeding for 2 months and
notices that her right breast has gradually become
swollen and painful to touch over the past week. On
physical examination her temperature is 38.20 C.
Which of the two pictures is compatible with the patients’
condition? Describe the lesions in the pictures. Give the
basis of your choice.
Describe the two pictures. Which among the two correlates
with the patient’s condition?
1. Give your diagnosis of the case.

3. What is the most common risk factor in the

development of this lesion?

3. Give the complications if untreated.

 SITUATION 2

A 20-year-old woman notes a mass in her right breast

during self-examination. Her physician confirms the
presence of 2 x 1 cm well-circumscribed movable firm
mass in the upper outer quadrant. There is no nipple
discharge nor pain. No axillary lymphadenopathy is
noted. The overlying skin of the breast appears normal.
Mammography confirms the presence of a rounded
density with no microcalcifications. The mass is
excised.
Briefly describe the two gross specimens.

Which of the above is more consistent with the patient’s

history and physical findings? Give reasons for your choice.
1. Match these lesions with the previous gross specimens.
2. Which of these two lesions is a tumor?
3. Is the tumor malignant or benign? Give basis.
4. Which of these lesions carries a greater risk of evolving
into malignancy? Explain.
5. Discuss the pathogenesis of these lesions.
 SITUATION 3

A 52-year-old woman feels a lump in her left

breast. On physical examination, her physician
palpates a 2.5 cm non-movable hard mass. A
biopsy is performed.
Indicate and describe the lesion. Is it benign or
malignant? Give the basis.
Which of the two lesions is consistent with the previous gross
picture? Indicate and describe.
The patient was advised mastectomy, but due to fear and
anxiety the patient went home to the province and was
treated by a “herbolario”.

Two years after she returns to Manila and seeks consultation.

This is how the breast looks like upon seeing by the
attending physician. Describe the gross findings. Discuss
the evolution of the lesion.
1. What are the risk factors in the development of
breast carcinoma?

2. What are the tumor markers that would help in

the diagnosis ?

3. What is the role of hormone receptor assays?

4. Give the most common pattern of spread of this

tumor.
 SITUATION 4

A 42 year old male patient is diagnosed to have

cirrhosis due to excess intake of alcohol for the
past 20 yrs. His breasts are noted to be
symmetrically enlarged.
Discuss the etio-
pathogenesis of the
breast enlargement.
Describe the histologic picture of this patient’s breast?
Is this benign or malignant?
The more serious specie.