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**Not cellular.
**Not myxoid.
May be present:
*[[Breast calcifications|Calcification]]:
**Purple globs (with concentric rings) on H&E = calcium phosphate.
***Q. How to remember? A. '''P'''urple = '''P'''hosphate.
**Calcium oxalate visible with (light) [[polarization]] - not associated with [[breast cancer|malignancy]].
**Often in the lumen of a gland, may be in the stroma.
**Calcific material typically has a well-demarcated border +/- "sharp corners".
**Radiologists can pick-up calcs (calcifications) that are approximately 100 micrometers; if "calcs" is on the requisition one needs to find calcs this size.<ref>MUA. 1 October 2010.</ref>
***The large calcs seen on radiology are approximately 1/5 - 1/6 the size of a HPF, if the field of view (FOV) is ~0.55 mm (as is the case with 22 mm-10x eye pieces and a 40x objective).
Notes:
*The architecture is more important than the cytologic features in the diagnosis of malignancy in the breast;<ref>RS. 4 May 2010.</ref> low grade tumours have distorted architecture but normal/near normal cytology.
===Image===
*[http://www.breastpathology.info/Images/calcs/FatNec1_700.jpg Breast with calcifications (breastpathology.info)].
*[http://www.wjso.com/content/7/1/70/figure/F3 Resting breast tissue (wjso.com)].
==Lactational changes==
*[[AKA]] secretory change, [[AKA]] lactational adenoma, [[AKA]] lactating adenoma <ref>URL: [Breast_pathology#Lactational_changes Breast_pathology#Lactational_changes. Accessed on: 3 October 2011.</ref>
===General===
*Lactational adenoma generally arises in during or in the few weeks after pregnancy.
*May be present focally in non-pregnant females.
*"Lactational adenoma"- circumscribed mass displacing the normal breast architecture (hyperplasia plus functional/physiologic change)
*"Lactational change"- normal breast tissue architecture preserved (functional/physiologic change).
ASIDE:
*Some believe ''lactational change'' and ''secretory change'' aren't the same...
**Lactational change = only in lactation.
**Secretory change = other times.
*This hair splitting is clinically irrelevant-- both are benign. Also, experts use the terms interchangeably.<ref name=pmid2879437>{{Cite journal | last1 = Tavassoli | first1 = FA. | last2 = Yeh | first2 = IT. | title = Lactational and clear cell changes of the breast in nonlactating, nonpregnant women. | journal = A...
</ref>
===Microscopic===
Features:<ref>URL: [http://flylib.com/books/en/2.953.1.9/1/ http://flylib.com/books/en/2.953.1.9/1/]. Accessed on: 6 August 2011.</ref>
*Glands dilated.
*Increased number of lobules.
**Relative decrease in intralobular and extralobular stroma.
*Luminal cells enlarged.
**Vacuolated cytoplasm.
**[[Hobnail morphology]] - hang into the lumen.
*Myoepithelial cells indistinct - after second trimester.
*Lactational "adenoma" may undergo infarction - Imagine what an infarcted lactational adenoma could look like in a FNA specimen!
DDx:
*[[Secretory carcinoma of the breast]].
====Images====
<gallery>
Image:Lactational_change_-_low_mag.jpg | Lactational change - low mag. (WC/Nephron)
Image:Lactational_change_-_high_mag.jpg | Lactational change - high mag. (WC/Nephron)
Image:Breast LactationalChange MP CTR.jpg|Breast - Lactational Change - medium power (SKB)
Image:Breast LactationalChange HP CTR.jpg|Breast - Lactational Change - high power (SKB)
Image:Breast LactationalAdenoma MP CTR.jpg|Breast - Lactational adenoma - medium power (SKB)
Image:Breast LactationalAdenoma HP CTR.jpg|Breast - Lactational adenoma - high power (SKB)
Image:Breast LactationalAdenoma LP SNP.jpg|Breast - Lactational adenoma - low power (SKB)
Image::Breast LactationalAdenoma MP SNP.jpg|Breast - Lactational adenoma - high power (SKB)
Image:Breast LactatingAdenoma (4) PA.JPG|Breast - Lactational adenoma - low power (SKB)
Image:Breast LactationalAdenoma MP SNP.jpg|Lactational adenoma - high power - in this example, the epithelium is flattened with clear bubbly cytoplasm (SKB)
Image:Breast LactatingAdenoma HP PA.JPG|Breast - Lactational adenoma - high power - shows snouting and decapitation secretion. (SKB)
</gallery>
www:
*[http://www.gfmer.ch/selected_images_v2/detail_list.php?cat1=2&cat2=9&cat3=0&cat4=3&stype=n Lactational changes (gfmer.ch)].
*[http://www.webpathology.com/image.asp?case=320&n=7 Lactational changes in an angiosarcoma of the breast (webpathology.com)].
*[http://www.lab.anhb.uwa.edu.au/mb140/CorePages/FemaleRepro/femalerepro.htm#LabMamm Lactating breast (uwa.edu.au)].
==Major Pathologic Patterns==
===General classification===
<!--
BREAST PATHOLOGY - SIMPLE
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{{familytree/start}}
{{familytree | | | | | | | | | | | A | | | | | | | | | | | |A='''Breast pathology'''}}
{{familytree | | | | |,|-|-|-|-|-|-|+|-|-|-|-|-|-|.| | | | | |}}
{{familytree | | | | B | | | | | X | | | | |C | | | | |B=Stromal<br>pathology|X=Miscellaneous|C=Glandular<br>pathology}}
{{familytree | |,|-|-|^|-|-|.| | | | | | |,|-|-|-|+|-|-|-|.| |}}
{{familytree | D | | | | E | | | | | F | | G | | H |D=Myxoid|E=Long slit-like<br>spaces|F=Simple<br>epithelium|G=Dilated|H=[[Breast pathology#Cellular lesions|Cellular lesions]]}}
{{familytree | |!| | | |,|-|^|-|.| | | | |!| | | |!| | | |!| |}}
{{familytree | I | | J | | K | | | L | | M | | N |I=[[Fibroadenoma]]|J=Malignant<br>features|K=Benign features|L=[[Tubular carcinoma of the breast|Tubular<br>carcinoma]]|M=[[FEA]], [[FCC]],<br>[[Columnar cell change|CCC]]|N=[[FEHUT]], Neoplastic,<br>Malignant}}
{{familytree | | | | | |!| | | |!| | | | | | | | | | | | | | |}}
{{familytree | | | | | O | | P | | | | | | | | | | | | | ||O=[[Phyllodes tumour|Malignant<br>phyllodes]]|P=[[Phyllodes tumour|Benign phyllodes]]}}
{{familytree/end}}
Notes:
*The challenges in breast pathology are in: the ''Simple epithelium'' category and the ''Cellular lesions'' category.
*''Neoplastic'' includes: ADH and LDH.
*''Malignant'' includes: DCIS, LCIS, ductal carcinoma (DC) and lobular carcinoma (LC), some papillary lesions.
*''Lobular carcinoma'' (a '''pitfall''') may appear to be a stromal problem, i.e. the stroma looks too cellular.
*''Miscellaneous'' includes rare tumours of the breast that do not fit into another category, i.e. [[metastases]], [[lymphoma]]s, [[melanoma]], sarcomas. Skin-related pathology is dealt within the ''[[dermatologic neoplasms]]'' article. ''[[Paget disease of the breast]]'', which may be seen in the context of malignant...
===Cellular lesions===
<!--
DDX - CELLULAR LESIONS OF BREAST
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{{familytree/start}}
{{familytree | | | | | | | | | | | | | C | | | | | | | | |C='''Cellular lesions<br>(Glandular)'''}}
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