🏅 Congratulations to Dr. Madhuri Wadehra & collaborators, Dr. Neda Moatamed & Dr. Wiriya Pipatsakulrojand, on receiving a Translational Research Fund Grant for their project "Tracking Subtype Switching in Triple-Negative Breast Cancer to Improve Treatment Response."

#PathSky #research #breastpath

Teen single breast lesion without other signs or symptoms.
Macro: multiple nodular aggregates
Histology: Myxoid Fibroadenoma
#PathSky #PediPath #BreastPath

Just published! Check out this latest article 👉🏻 HER2 amplification is rare (1.7%) in low-grade, tubule-forming breast cancers with 2+ HER2 IHC; findings suggest ISH may be unnecessary in this subset #breastpath #IHCpath #pathsky

#UsualEpithelialHyperplasia doesn’t get more florid than this.
#Cytokeratin5 positive.
#ER variable.
Note that the apocrine cells next door are CK5 and ER negative.
#BreastPath
#pathology
#BlueskyPath
😉

✅ Fibrocystic change (including apocrine metaplasia)
Apocrine metaplasia involves replacement of epithelium by apocrine cells (large, eosinophilic granular cytoplasm, round nuclei, prominent nucleoli, apical snouts)
In FCC, these cells line pre-existing/dilated ducts and cysts.
#BreastPath

❌ Intraductal papilloma with apocrine metaplasia:
True papillary fronds having fibrovascular cores lined by both epithelial cells (showing apocrine metaplasia here) AND myoepithelial cells
Typically in a dilated duct
apocrine tufting without FVCs is not intraductal papilloma
#BreastPath #Pathology

❌ Apocrine Adenosis: proliferative lesion
Represents adenosis (proliferation of glands/acini) where the lining cells show apocrine metaplasia
Key: lobulocentric proliferation of glands/acini lined by apocrine cells, often with surrounding sclerosis
#BreastPath #PathSky #Pathology #PathTwitter

All these options can involve apocrine cells, but which feature favors fibrocystic change?
A) Apocrine cells lining cysts
B) Stromal fibrosis around ducts
C) True papillae
D) Lobulocentric proliferation
#BreastPath #PathSky #Pathology #PathTwitter

MRI core needle biopsy for a non-mass enhancing lesion.
What is your interpretation?
A) Fibrocystic change
B) Intraductal papilloma
C) Apocrine adenosis
#BreastPath #PathSky #Pathology #PathTwitter
🔬 dpa-dapa.com/public/displ...

✅Fibromatosis
Infiltrative spindle cell proliferation
Minimal atypia
Locally aggressive, entraps normal breast mimicking carcinoma
Inactivated Wnt/β-catenin via APC/CTNNB1 mutation
✅Nuclear β-catenin+, actin+, desmin-
🔬 dpa-dapa.com/public/displ...
#BreastPath #Pathology

❌Myofibroblastoma
Well-circumscribed spindle cell tumor
Uniform bland spindled cells in fascicles
Interspersed hyalinized collagen
Entrapped epithelial elements is unusual
CD34+, desmin+, ER+, loss of nuclear RB1
🔬 dpa-dapa.com/public/displ...
#BreastPath #Pathology

❌Fibrous mastopathy
Dense keloid-like collagen replacing breast parenchyma
Perivascular and periductal lymphocytic infiltrates
More common in long-standing type 1 diabetes or autoimmune diseases
No epithelial proliferation or atypia
#BreastPath #Pathology
🔬 dpa-dapa.com/public/displ...

❌Myoid hamartoma
Well-circumscribed developmental malformation
Normal breast entrapped by smooth muscle bundles
🔬 dpa-dapa.com/public/displ...
#BreastPath #Pathology

The IHC below confirms the diagnosis. What is it?
A) RB1
B) STAT6
C) β-catenin
D) Desmin
#BreastPath #Pathology #PathTwiter

Breast core needle biopsy. Diagnosis?
A) Myofibroblastoma
B) Myoid hamartoma
C) Fibrous mastopathy
D) Fibromatosis
#BreastPath #Pathology #PathTwiter #PathSky
🔬 dpa-dapa.com/public/displ...

✅Sclerosing adenosis
✅Benign, myoepithelial cells present
Glands distorted with compressed lumens
Stroma sclerotic / collagenous
Architecture lobulocentric (retained at low power)
#PathSky #BreastPath #PathTwitter #Pathology
🔬 dpa-dapa.com/public/displ...

❌Radial Scar
Benign, myoepithelial cells present
Glands entrapped & distorted
Stroma sclerotic with elastotic core
Architecture with central scar and radiating structures
#PathSky #BreastPath #PathTwitter #Pathology
🔬 pathpresenter.net/public/displ...

❌Microglandular adenosis
Benign, but lacks myoepithelial cells
Glands with open round lumens with colloid-like contents
Architecture haphazard & infiltrative
#PathSky #BreastPath #PathTwitter #Pathology
🔬 dpa-dapa.com/public/displ...
🔬 tumourclassification.iarc.who.int/Viewer/Index...

❌Tubular Carcinoma
Malignant, lacks myoepithelial cells
Glands with open angulated lumens
Stroma desmoplastic
Architecture haphazard & infiltrative
#PathSky #BreastPath #PathTwitter #Pathology
🔬 dpa-dapa.com/public/displ...

Breast core needle biopsy.

Is it #TooFarToDiagnosis?

A) Tubular carcinoma
B) Microglandular adenosis
C) Sclerosing adenosis
D) Radial scar
#PathSky #BreastPath #PathTwitter #Pathology
🔬 dpa-dapa.com/public/displ...

Beware of mucin lobules associated with vessels in a breast biopsy 📸 1. A key feature of mucinous carcinoma 📸 2. Seen on FNA's but easily missed on biopsies if no epithelial islands seen.
#pathology
#BreastPath
#BluePath
😉

❌Flat Epithelial Atypia (FEA)
low-grade cytologic atypia: monotonous, mildly enlarged nuclei
"flat" = NO architectural disorder
Apical snouts & luminal secretions
TDLUs may be dilated/cystic
#BreastPath #PathSky #Pathology
🔬 pathpresenter.net/public/displ...
🔬 dpa-dapa.com/public/displ...

This (plus some others I included here) is columnar cell change, distinguished by its LACK of ___
A) cellular stratification
B) clonal/monotonous cells
C) nuclear polarization
D) associated calcification
#BreastPath #PathSky #PathTwitter #Pathology

🧐🧐 Is it #TooCloseToDiagnose?

How would you interpret this core needle biopsy?

A) Flat epithelial atypia
B) Atypical ductal hyperplasia
C) Columnar cell change
🔬 pathpresenter.net/public/displ...
#BreastPath #PathSky #PathTwitter #Pathology

The great deceptor at work again! #ColumnarCellChange colonised by #InsituLobularNeoplasia.
Top tip! Always look carefully at busy columnar lined ducts.
😉
#pathology
#BreastPath
#BluePath

✅Lymphocytic mastopathy
Dense keloid-like collagen replacing breast parenchyma
Perivascular and periductal lymphocytic infiltrates
More common in long-standing type 1 diabetes or autoimmune diseases
No epithelial proliferation or atypia
Mammography: frequently negative
#BreastPath #PathSky

❌Fibroadenoma
Biphasic tumor (epithelial + stromal)
Stroma can become densely collagenized (sclerotic variant)
#BreastPath #Pathology #PathSky

❌Fibromatosis
Infiltrative spindle cell proliferation
Minimal atypia
Locally aggressive, entraps normal breast mimicking carcinoma
Inactivated Wnt/β-catenin via APC/CTNNB1 mutation
Nuclear β-catenin+, actin+, desmin-
#BreastPath #Pathology #PathSky

This is lymphocytic mastopathy
-AKA diabetic mastopathy

Which of the following is true?

A) only seen in diabetics
A) recurrence is rare
B) negative on mammography
D) β-catenin is nuclear (+)
#BreastPath #Pathology #PathSky

Breast biopsy shows epithelioid cells, dense collagen, and lymphocytic aggregates.

What could it be?🧐🧐

A) Myofibroblastoma
B) Fibroadenoma
C) Lymphocytic mastopathy
D) Fibromatosis
#BreastPath #Pathology #PathSky