Invasive breast carcinoma - IARC

Tumours of the nipple
V. Eusebi
K.T. Mai
A. Taranger-Charpin
Nipple adenoma
Definition
A compact proliferation of small tubules
lined by epithelial and myoepithelial
cells, with or without proliferation of the
epithelial component, around the collecting
ducts of the nipple.
ICD-O code 8506/0
Synonyms
Nipple duct adenoma; papillary adenoma;
erosive adenomatosis; florid papillomatosis;
papillomatosis of the nipple,
subareolar duct papillomatosis.
Historical annotation
Under the designation of nipple adenoma
(NA), several morphological lesions
(some of which overlap) have been
included {1356,2222,2429,2894}.
1. The largest group consists of cases
showing an adenosis pattern in its classical
form, with sclerosis and/or pseudoinvasive
features, sclerosing papillomatosis
{2429}, and infiltrative epitheliosis
{149}).
2. Epithelial hyperplasia (papillomatosis
{2429}; epitheliosis {149}) of the collecting
ducts.
3. Lesions composed of a combination of
epithelial hyperplasia and sclero s i n g
adenosis.
Fig. 1.156 Adenoma of the nipple. There is no significant
epithelial proliferation in the tubules in
this case.
Fig. 1.155 Adenoma of the nipple. A compact aggregate of tubules replaces the nipple stroma.
E p i d e m i o l o g y
NA is rare with a wide age range fro m
20 to 87 years) {2894} and may occur in
males {2429}.
Clinical features
P resenting symptoms are most frequently
a sanguineous or serous discharge
and occasionally erosion of the
nipple or underlying nodule {2222}.
H i s t o p a t h o l o g y
In the adenosis type, proliferating two
cell layered glands sprout from and
c o m p ress the collecting ducts {2222}
resulting in cystic dilatation of the latter
and formation of a discrete nodule. The
e p i d e rmis may undergo hyperkeratosis.
R a rely the adenosis expands to cause
e rosion of the epidermis {2429}.
When the sclerosis and pseudoinfiltrative
patterns are prominent, an invasive
c a rcinoma is closely simulated. The
b a c k g round stroma shows loose myxoid
features, large collagenous bands
or elastosis {149}.
Epithelial hyperplasia may be florid
within the tubules of adenosis or mainly
within the collecting ducts. Enlargement
of the galactophore ostia and
e x p o s u re of the epithelial pro l i f e r a t i o n
to the exterior in a fashion re m i n i s c e n t
of “ectropion” of the uterine cervix may
o c c u r.
Prognosis and predictive factors
Occasional re c u r rences have been
described after incomplete excision
{2425}. Association with carcinoma
has been re p o rted but is rare {1367,
2429}.
Syringomatous adenoma
D e f i n i t i o n
A non metastasizing, locally re c u r re n t ,
and locally invasive tumour of the nipp
l e / a reolar region showing sweat duct
d i ff e re n t i a t i o n .
ICD-O code 8 4 0 7 / 0
104 Tumours of the breast