Cysts and fibrosis; Hyperplasia and
atypical hyperplasia
When biopsies (samples) of breast tissue are studied under
the microscope, it is possible to identify different types of fibrocystic
breast condition. Some cases of fibrocystic breast condition show A) little disturbance of the breast tissue. Other
cases involve a large number of cysts, along with B) fibrous (scar) tissue,
in the breast tissue. Additionally, in some cases of fibrocystic breast
condition, C) the breast cells do not have a normal appearance.
How does histology looks
like?? Too many Cysts and excess fibrosis which is more than normal fibrosis
in healthy breasts: : Usually, even when the breast is not stimulated to
produce milk, some secretions are produced by the secretory glandular cells.
These secretions are normally reabsorbed "downstream" in the ducts.
However, when there has been tissue damage and scarring (fibrosis) in the
breast, these secretions may be trapped in the glandular portions of the
breasts, thereby leading to the formation of fluid-filled sacs called cysts. In
some areas of the breasts, there may be excessive fluid secretions due to
stimulation by hormone-like substances. The resulting cysts may remain
microscopic or enlarge until they contain several teaspoons or even tablespoons
of fluid. These larger cysts may be felt as palpable (capable of being detected
by touching) breast lumps. Even
microscopic cysts may sometimes be felt as palpable lumps if many cysts are
clustered together and there is a buildup of fibrous (scar) tissue around the
cysts.
B) Glandular cellular atypia: Hyperplasia and atypical hyperplasia of
breast cells: With repeated stimulation from normal hormones, and possibly
the effects of many of the hormone-like substances produced in the breast, a
few of the epithelial cells (cells that line the ducts in the breast) may
eventually lose some of their genetic controls, which normally limit their
multiplication (cell division). When this happens, cells may proliferate,
leading to an abnormal architectural pattern of the epithelial cells. This
over-proliferation of cells is termed hyperplasia. Sometimes these
proliferating cells begin to appear abnormal and to look different from one
another. They are now described as "atypical." As other more normal
cells continue to cycle, die and break down, these atypical cells can move in,
spread out, and accumulate. This extensive overgrowth and accumulation of
atypical cells is called atypical hyperplasia.
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