Traditional Final Diagnosis:

Right breast, excisional biopsy:

Fibroadenoma with Lobular carcinoma in situ

The Doctor's Doctor Translated Diagnosis:

Right breast biopsy showing the following:
1. Fibroadenoma

This is a benign nodule composed of a mixture of breast lining cells and the fibrous tissue that supports it. 

2. Lobular Carcinoma in Situ

This is a proliferation of cells which have a malignant appearance but have not invaded into the surrounding breast fibrous tissue.  These cells are present within the fibroadenoma (See comment). 

Received is a biopsy specimen which measures 2 x 2 x 1.5 cm.  It is composed of tan-yellow tissue with no orientation.  The margins are inked black.  Serial cross sections reveal tan-white tissue with a single circumscribed nodule that measures 0.5 cm in greatest diameter.  Serially sectioned and totally embedded in 3 casettes.

The Doctor's Doctor Gross Description:

The surgeon removed a piece of breast tissue that measured about 3/4 x 3/4 x 1/2 inches. After placing ink on the margins, the tissue was sliced and a nodule was found which measured about 1/4 inch.  All of the tissue was prepared for examination under the microscope.

Microscopic sections show a circumscribed nodule of focally hyperplastic ducts enveloped by a paucicellular stroma with myxoid change.  There are no areas of stromal overgrowth.  The stromal cells are bland with no mitotic figures found.    Within some of the ducts are a uniform expansion of lobular cells, some of which have a signet ring appearance.  No invasion is identified.

The Doctor's Doctor Microscopic Diagnosis:

Under the microscope, the tissue shows breast tissue with two lesions.  The first is a fibroadenoma which shows ducts (the glands that produce milk) which are surrounded by benign fibrous tissue.  Within some of these ducts, are cancerous cells which have not invaded into the surrounding tissue. 

The Doctor's Doctor Comments

A fibroadenoma is a benign condition, which has been classified under the heading of fibrocystic disease of the breast.  Within this benign lesion, however, are cancerous cells (lobular carcinoma in situ), which have not invaded the surrounding fibrous tissue, and thus do not have the potential to metastasize or spread beyond the breast.    Lobular carcinoma in situ is regarded as a risk factor for the development of invasive breast cancer in both this breast and the opposite breast.  Please discuss your treatment options with your physician.