Dr., Could you please explain my Path Report. I see "Benign" but I just don't know what everything else means....
Microscopic Diagnosis: Right breast lesion, excision with needle localization: Moderately proliferative fibrocystic change without atypia. Duct ectasia with ruptured ducts with inflammation. Apocrine metaplasia. Dystrophic califications. Frozen section diagnosis confirmed.
OR Consultation: One frozen section is performed
Microscopic Description: Permanent sections confirm the initial impression and demonstrate benign breast tissue with a moderate component of intralobular stromal fibrosis and non-proliferative fibrocystic change. Additional sections demonstrate moderately proliferative fibrocystic change. Several of the ducts are ruptured with an inflammatory reaction with foamy histiocytes. There is no epithelial atypia. Other sections demonstrate cluster of benign cysts, some of which display apocrine metaplasia and dystrophic calfication.
The surgeons nurse told me they use to get pathology repports that either said malignant or benign...........after reading some of these paathology reports I can readily see why they say it was much better back then. They really like to get prolific with their reports. I shall leave it to the doctors.
My take on the report is that you have significant fibrocystic changes (those ruptured ducts, cysts, and stromal fibrosis, etc), which are all benign.
Here is a simple definition of apocrine metaplasia I found. I think that apocrine metaplasia, like many features of fibrocystic change, is mostly considered to not increase risk of cancer, but some are studying it and other fibrocystic changes to see if there is any possible link.
"Apocrine metaplasia denotes a benign lesion that has no increased risk for the development of breast cancer. It is most commonly seen in the lining of cysts. Apocrine means a type of glandular secretion in which the end part of the secreting cell is cast off along with the secretion products that have accumulated. Metaplasia means a change in the type of cells in a tissue to another form of cells that are not normal for that tissue. This term probably is describing the origin of the increased number of cells in the walls of a cyst or lesion in the breast tissue. I want to emphasize that it is not a cancerous condition."
My take on definitions of dystrophic calcification is the presence of calcium deposits, typically a response to some "abnormal" condition such as fat necrosis or inflammation (ie your cysts and ruptured ducts).
As a layperson, I would interpret this report to say that you have grumpy fibrocystic breasts. Get regular digital mammograms and watch your caffeine intake. Anecdotal evidence also suggests that vitamin E and B vitamins help fibrocystic breasts.
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