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Raganoonan C, Fairbairn JK, Williams S, Hughes LE. Careers. When histopathology on core biopsy reveals a higher-risk lesion, such as atypical lobular hyperplasia, excisional biopsy may be indicated to rule out malignancy. Fibroadenoma is a very common benign neoplasm typically occurring in patients between the ages of 20 and 35 years. The myoepithelial layer is hard to see at times. Nigam JS, Tewari P, Prasad T, Kumar T, Kumar A. Cureus. Epidemiology. Radiology of fibroadenoma. At the time the article was created The Radswiki had no recorded disclosures. and transmitted securely. 2022 Jul;194(2):307-314. doi: 10.1007/s10549-022-06631-2. Indian J Plast Surg. Contact | ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Sat-Muoz D, Martnez-Herrera BE, Quiroga-Morales LA, Trujillo-Hernndez B, Gonzlez-Rodrguez JA, Gutirrez-Rodrguez LX, Leal-Corts CA, Portilla-de-Buen E, Rubio-Jurado B, Salazar-Pramo M, Gmez-Snchez E, Delgadillo-Cristerna R, Carrillo-Nuez GG, Nava-Zavala AH, Balderas-Pea LM. Contributed by Gary Tozbikian, M.D. National Library of Medicine Fibroepithelial tumours of the breast-a review. 2021 Jan 10;13(1):e12611. The study included women aged 18-85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. . emailE=('rouse' + '@' + 'stan' + 'ford.edu')
The border is well-circumscribed where seen.
2005 Jul 21;353(3):229-37. doi: 10.1056/NEJMoa044383. It is usually single, but in 20% of cases there are multiple lesions in the same breast or bilaterally. They fall under the broad group of "adenomatous breast lesions".. Complex fibroadenomas are often smaller than simple fibroadenomas (1.3 cm compared with 2.5 cm in simple fibroadenomas). Pleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of epithelial (ductal) cells along with myoepithelial components, having a malignant potentiality. 2003 Oct;12(5):302-7. doi: 10.1016/s0960-9776(03)00123-1. Before (a) In a 42 year old woman with a right axillary palpable lump, the mammogram shows a well-defined, gently lobulated, oval nodule in the right axilla (white arrow).Accessory breast tissue is also seen (red arrow). Keywords: We welcome suggestions or questions about using the website. ~50% of these tend to be lobular carcinoma in situ (LCIS), ~20% infiltrating lobular carcinoma, ~20%ductal carcinoma in situ (DCIS), and the remaining 10% are infiltrating ductal carcinoma. Complex fibroadenomas tend to occur in older patients (median age, 47 years) compared with simple fibroadenomas (median age, 28.5 years). Visual survey of surgical pathology with 11,912 high-quality images of benign and malignant neoplasms & related entities. Lerwill MF. Fibroadenoma, abbreviated FA, is a common benign tumour of the breast. Excision of breast fibroepithelial lesions: when is it still necessary?-A 10-year review of a regional centre. . We welcome suggestions or questions about using the website. 8600 Rockville Pike 1994 Jul 7;331(1):10-5. A simple fibroadenoma does not raise your risk for breast cancer. Robert V Rouse MD rouse@stanford.edu. More frequent in young and black patients. The https:// ensures that you are connecting to the 2006 Oct;17(5):233-8. doi: 10.1111/j.1365-2303.2006.00333.x. (b) Ultrasound shows a well-defined oval nodule in the right axilla which was confirmed to be a fibroadenoma on core biopsy. Sosin M, Pulcrano M, Feldman ED, Patel KM, Nahabedian MY, Weissler JM, Rodriguez ED. 2001 Feb 19;174(4):185-8. doi: 10.5694/j.1326-5377.2001.tb143215.x. Complex fibroadenomas are often smaller than simple fibroadenomas (1.3 cm compared with 2.5 cm in simple fibroadenomas). Cancer. Focally, the lesion approaches the inked margin; partial lesion transection cannot be excluded. J Natl Cancer Inst. Adipocytokines and Insulin Resistance: Their Role as Benign Breast Disease and Breast Cancer Risk Factors in a High-Prevalence Overweight-Obesity Group of Women over 40 Years Old. pathology researchers that rely upon this methodology to perform tissue analysis in research. Clipboard, Search History, and several other advanced features are temporarily unavailable. Become a Gold Supporter and see no third-party ads. The immunostains used in breast pathology for the . Minimal mitotic activity is present (2 mitosis/10 HPF, where 1 HPF ~ 0.2376 mm*mm). 1987 Apr;57(4):243-7. Sabate, JM. Epub 2020 Aug 26. da Silva EM, Beca F, Sebastiao APM, Murray MP, Silveira C, Da Cruz Paula A, Pareja F, Wen HY, D'Alfonso TM, Edelweiss M, Weigelt B, Brogi E, Reis-Filho JS, Zhang H. J Clin Pathol. PMC Epub 2010 Jun 22. 2010 Dec;17(12):3269-77. doi: 10.1245/s10434-010-1170-5. IHC can aid in visualizing the myoepithelial layer. We consider the term merely descriptive. | Log in | Nigam JS, Tewari P, Prasad T, Kumar T, Kumar A. Cureus. This site needs JavaScript to work properly. Epithelial component often not compressed - as in fibroadenoma. At a mean follow-up of 2 years, we found a low incidence of malignancy in complex fibroadenomas. MeSH Essentials in Bone and Soft-Tissue Pathology - Jasvir S. Khurana 2010-03-10 Essentials in Bone and Soft-Tissue Pathology is a concise and well-illustrated handbook that captures the salient points of the most common problems in bone and soft-tissue . No cytologic atypia is present. Unable to process the form. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). ; Hashimoto, B.; Wolverton, D. et al. Women with complex fibroadenomas may therefore be managed with a conservative approach, similar to the approach now recommended for women with simple fibroadenomas. 1994 Jul 7;331(1):10-5. An official website of the United States government. Cardeosa G. Clinical breast imaging, a patient focused teaching file. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland.It derives its name from the architectural Pleomorphism (variable appearance) seen by light . The site is secure. Patients with complex lesions were 18.5 years older (median age, 47 years; range, 21-69 years) than patients with noncomplex fibroadenomas (median age, 28.5 years; range, 12-86 years) (p < 0.001). This model affords the opportunity for investigators to study the process of mammary carcinogenesis over a very short latency and to investigate early events in this process. }
Stroma is generally more sparse than in conventional fibroadenoma. Breast MRI during pregnancy and lactation: clinical challenges and technical advances. (Sep 2005). Semin Diagn Pathol. Background: Fibroadenoma. Tumors of the Mammary Gland, Atlas of Tumor Pathology, AFIP Third Series, Fascicle 7, 1993. HHS Vulnerability Disclosure, Help Well circumscribed tumor with bulging cut surface, Fibroadenoma with atypical ductal hyperplasia, Sign up for our What's New in Pathology e-newsletter, Copyright PathologyOutlines.com, Inc. Click, 30150 Telegraph Road, Suite 119, Bingham Farms, Michigan 48025 (USA). Complex Breast Fibroadenoma; Complex Fibroadenoma; Complex Fibroadenoma of Breast; Complex Fibroadenoma of the Breast: Definition. FNA smears from CFA cases showed discohesiveness, enlarged nuclei, prominent nucleoli, and fewer myoepithelial cells more often than NCFA. Int J Fertil Womens Med. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2022 Feb;75(2):133-136. doi: 10.1136/jclinpath-2020-207062. Conclusions: Hartmann LC, Sellers TA, Frost MH, Lingle WL, Degnim AC, Ghosh K, Vierkant RA, Maloney SD, Pankratz VS, Hillman DW, Suman VJ, Johnson J, Blake C, Tlsty T, Vachon CM, Melton LJ 3rd, Visscher DW. Results: We further re-assessed detailed characteristics of each FNA smears to identify cytomorphological features of CFA. National Library of Medicine Diagn Cytopathol. The sections show a lesion with a pale mildly cellular stroma, and bland glandular elements. Methods: 2022 May 17;19(10):6093. doi: 10.3390/ijerph19106093. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Nissan N, Bauer E, Moss Massasa EE, Sklair-Levy M. Insights Imaging. Only one malignancy, an invasive lobular carcinoma, was found in 63 complex fibroadenomas (1.6%). Fibroadenomas are benign while phyllodes tumor range from benign, indolent neoplasms to malignant tumors capable of distant metastasis. This website is intended for pathologists and laboratory personnel but not for patients. Giant fibroadenoma. official website and that any information you provide is encrypted Would you like email updates of new search results? Fine-needle aspiration of gray zone lesions of the breast: fibroadenoma versus ductal carcinoma. Gland Surg. Complex fibroadenomas were diagnosed in 63 of 401 fibroadenomas (15.7%) found at consecutive percutaneous needle or excisional surgical bi-opsy. Unauthorized use of these marks is strictly prohibited. Please enable it to take advantage of the complete set of features! No stromal overgrowth is seen.
2021 Jan 10;13(1):e12611. (Most fibroadenomas in adolescents are typical, adult type fibroadenomas and should be diagnosed as such) Giant fibroadenoma Tumors >500 g or disproportionally large compared to rest of breast; More frequent in young and black patients; We consider the term merely descriptive; May be either adult type or juvenile fibroadenomas Fibroadenoma - slit-like spaces (webpathology.com), Fibroadenoma - lobulated appearance (webpathology.com), Tubular adenoma of the breast (webpathology.com), http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970216-9, http://www.imagingpathways.health.wa.gov.au/includes/dipmenu/image/image.html, http://www.breastpathology.info/fibro_variants.html#juvenile, http://www.breastpathology.info/fibro_variants.html#complex, https://librepathology.org/w/index.php?title=Fibroadenoma&oldid=51069, Attribution-NonCommercial-ShareAlike 4.0 International, abundant (intralobular) stroma usu. When histopathology on core biopsy reveals a higher-risk lesion, such as atypical lobular hyperplasia, excisional biopsy may be indicated to rule out malignancy. font-weight: bold;
Histopathology of fibroadenoma of the breast. The pathology is in the stroma; so, the lesion is really a misnomer by the naming rules. The definitive diagnosis is made histologically by the presence . 1.5 - 2 times increased risk. MeSH Fibroadenoma is the most common benign tumor of the female breast. May be hyalinized (dark pink) if infarcted. No cytologic atypia is present. Bethesda, MD 20894, Web Policies +/-"Stromal overgrowth" = large area where there is a 'loss of glands'. 3 Giant (juvenile or cellular) fibroadenoma is a . Would you like email updates of new search results? More frequent in young and black patients. Women with complex fibroadenomas may therefore be managed with a conservative approach, similar to the approach now recommended . Schnitt: Biopsy Interpretation of the Breast, 3rd Edition, 2017, WHO Classification of Tumours Editorial Board: Breast Tumours, 5th Edition, 2019, Adenosis or lobulocentric processes with increase in glandular elements of terminal duct lobular unit (TDLU) with stromal fibrosis / sclerosis that distorts and compresses glands, Preserved 2 cell layer (inner epithelial and outer myoepithelial cells), Enlarged terminal duct lobular unit with distortion by stromal fibrosis / sclerosis, Coalescent foci of typical sclerosing adenosis, Rare; sclerosing adenosis with predominance of myoepithelial cells, presents as multifocal microscopic lesions (, Most frequent in third to fourth decades but occurs over a wide age range, Found in 12 - 28% of all benign and 5 - 7% of malignant biopsies (, Terminal duct lobular unit; otherwise, no specific location within the breast, Often an incidental finding or detected by screening, Can present as a palpable mass if nodular adenosis / adenosis tumor, Histologic examination of tissue with or without immunohistochemistry, Variable depending on the size / extent of breast involvement, If focal, may not be visualized (i.e. The .gov means its official. Contact us for pricing; complex fibroadenoma pathology outlines Clipboard, Search History, and several other advanced features are temporarily unavailable. Before 1997 Sep-Oct;42(5):278-87. An official website of the United States government. It is a rare benign rapidly growing breast mass in adolescent females. Complex fibroadenoma with sclerosing adenosis (crowded glands in a fibrotic stroma) (hematoxylin-eosin; original magnification 10). 2015 Aug;4(4):312-21. doi: 10.3978/j.issn.2227-684X.2015.06.04. Med J Aust. As the name suggests, is typically found in younger patients. H&E stain. Fibroadenomas may demonstrate estrogen and progesterone sensitivity and may grow during pregnancy. Breast, right, 2:00 zone 2, ultrasound guided core biopsy: Well developed leaf-like architecture, with accompanied increased stromal cellularity, Prominent mitotic activity 3/10 high power fields or the finding of 3 or more characteristic histologic features (stromal overgrowth, fat infiltration, stromal fragmentation, subepithelial stromal condensation,
Home > E. Pathology by systems > Reproductive system > Female genital system > Breast > complex fibroadenoma, Complex fibroadenoma is a sub type of fibroadenoma harbouring one or more of the following features: Accessibility Stanton SE, Gad E, Ramos E, Corulli L, Annis J, Childs J, Katayama H, Hanash S, Marks J, Disis ML. 2020 Dec;53(3):439-441. doi: 10.1055/s-0040-1716187. This page was last edited on 5 January 2021, at 19:25. No stromal overgrowth is seen. doi: 10.7759/cureus.12611. Accessibility Closely packed uniform tubules, lined by a single layer of epithelial cells and an attenuated myoepithelial cell layer. They fall under the broad group of adenomatous breast lesions. No apparent proliferative activity is present. No calcifications are evident. It increases in size during pregnancy and tends to regress with age. No leaf-like architecture is present. The sections show a lesion with a pale mildly cellular stroma, and bland glandular elements. Indian J Pathol Microbiol. The term fibroadenoma combines the words "fibroma," meaning a tumor made up of fibrous tissue, and "adenoma," a tumor of gland tissue. N Engl J Med. official website and that any information you provide is encrypted cysts larger than 3 mm. Pathology. Complex fibroadenomas may increase the risk of breast cancer. Epub 2015 Jan 13. Conventional fibroadenomas (FAs) are underpinned by recurrent MED12 mutations in the stromal components of the lesions. Complex fibroadenoma. Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Flat epithelial atypia and risk of breast cancer: A Mayo cohort study. Tumors >500 g or disproportionally large compared to rest of breast. Multiple, giant fibroadenoma. PMID: 8202095 (Free), 1996 - 2023 Humpath.com - Human pathology epithelial calcifications 2006 Jul;49(3):334-40. It should be distinguished from other benign masses of the breast by proper evaluation and management. ; Menet, E.; Tardivon, A.; Cherel, P.; Vanel, D. (Apr 2005). The purpose of this study is to examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. The authors declare that they have no conflicts of interest. 8600 Rockville Pike Epub 2021 Jul 12 doi: 10.1371/journal.pone.0253764. Unable to load your collection due to an error, Unable to load your delegates due to an error. official website and that any information you provide is encrypted Giant breast tumours of adolescence. Fibroadenoma was identified in 2136 women [noncomplex, 1835 (85.9%); complex, 301 (14.1%)]. http://surgpathcriteria.stanford.edu/,
In this review, the pathology of the fibroadenoma and phyllodes tumour is revisited, with emphasis on diagnostic and management implications. Objective: No large cysts are seen. ; Cha, I.; Bauermeister, DE. May be either adult or juvenile type. document.write('')
On gross pathology, a rubbery, tan colored, and 2006 Oct;192(4):545-7. doi: 10.1016/j.amjsurg.2006.06.011. SIR for noncomplex fibroadenoma was 1.49 (95% CI 1.26-1.74); for complex fibroadenoma, it was 2.27 (95% CI 1.63-3.10) (test for heterogeneity in SIR, P = .02). From excisional biopsy or resected specimens of fibroadenoma (FA) cases treated at our institution from 2004 to 2013, we chose 46 patients who underwent FNA before a diagnosis of FA was established. Complex fibroadenomas are smaller and appear at an older age. Diagnosis in short. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. The luminal cell is epithelial. The https:// ensures that you are connecting to the FOIA doi: 10.7759/cureus.12611. 1996 Nov;29(5):411-9. invasive breast carcinoma, ductal carcinoma in situ, lobular carcinoma in situ) and atypical epithelial proliferations (e.g. Findings can confirm benign nature of disease but are nonspecific, resembling fibroadenoma or phyllodes tumor (Indian J Pathol Microbiol 2005;48:260) Finding plump spindled mesenchymal cells is suggestive (Diagn Cytopathol 2005;32:345) PMID: 11345838 (Free), Long-term risk of breast cancer in women with fibroadenoma. sclerosing adenosis and Complex fibroadenoma is a sub type of fibroadenomaharboring one or more of the following features: Complex fibroadenomas tend to occur in older patients (median age, 47 years) compared with simple fibroadenomas (median age, 28.5 years). Usual ductal hyperplasia[TIAB] free full text[SB], Benign intraductal proliferation of progenitor epithelial cells with varying degrees of solid or fenestrated growth, Streaming growth pattern with fenestrated spaces and lack of cellular polarity, Immunoreactive for high molecular weight cytokeratins, Associated with slight increase in subsequent breast cancer risk (1.5 - 2 times), Also called epithelial hyperplasia, intraductal hyperplasia, hyperplasia of usual type, ductal hyperplasia without atypia, epitheliosis, Most significant finding in 20% of benign breast biopsies (, Proliferation of CK5+ progenitor cells that can differentiate along glandular or myoepithelial lineages; glandular progenitor cells appear to predominate and show intermediate levels of differentiation (, Diagnosis by histologic examination of tissue removed via biopsy or surgical excision, No specific mammographic findings; occasional examples are associated with microcalcifications, Can involve an underlying lesion (e.g. Am Surg. The purpose of this study is to examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. The site is secure.
We found that 15 cases fulfilled the diagnostic criteria of CFA, in which 7 (46.7 %) had an FNA diagnosis of "suspicious for malignancy" or "indeterminate" while only 2 NCFA cases had that of "indeterminate" (p = 0.004). There are numerous reports that the general risk of developing cancer in the breast parenchyma is elevated among women with complex fibroadenomas; these women are 3.1-3.7 times more likely to develop breast cancer than women in the general population (compared with a relative risk of 1.9 times in women with non-complex fibroadenomas). A. Because of their high mobility, they are also referred to as mouse in the breast/breast mouse. This site needs JavaScript to work properly. We evaluated the clinical and imaging presentations of complex fibroadenomas; compared pathology at core and excisional biopsy; and contrasted age, pathology, and size of complex and simple fibroadenomas using the Student's t test. Background Fibroepithelial lesions of the breast include fibroadenoma (FA) and phyllodes tumor (PT). This website is intended for pathologists and laboratory personnel but not for patients. In the male breast, fibroepithelial tumors are very rare, . It is important to recognize the disease entity and characteristic cytomorphological findings of CFA to reach accurate FNA diagnosis of breast lesions. Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer WD Jr, Rados MS, Schuyler PA. An official website of the United States government. Over time, a fibroadenoma may grow in size or even shrink and disappear. Ann Surg Oncol. 1999 Aug;16(3):235-47. No large cysts are seen. Carcinoma Breast-Like Giant Complex Fibroadenoma: A Clinical Masquerade. "Fibroepithelial lesions with cellular stroma on breast core needle biopsy: are there predictors of outcome on surgical excision?". Tumor-associated autoantibodies from mouse breast cancer models are found in serum of breast cancer patients. Results: He Q, Cheng G, Ju H PLoS One 2021;16(7):e0253764. Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer WD Jr, Rados MS, Schuyler PA. N Engl J Med. Degnim AC, Frost MH, Radisky DC, Anderson SS, Vierkant RA, Boughey JC, Pankratz VS, Ghosh K, Hartmann LC, Visscher DW. Although malignant transformation in FA is rare, there is evidence of an association with breast carcinoma, particularly in middle-aged females with associated risk factors, such as a strong family history and/or BRCA-1/2 mutations. They fall under the broad group of "adenomatous breast lesions". We sought to evaluate the incidence of complex fibroadenoma on biopsy and to propose decision criteria for managing patients with these breast lesions. The border is well-circumscribed where seen.
Sclerosing adenosis and risk of breast cancer. This patient had atypical lobular hyperplasia at core needle biopsy. Most common benign tumor of the female breast. Age-related lobular involution and risk of breast cancer. .style1 {
FNA of CFA can lead to erroneous or indeterminate interpretation, due to proliferative and/or hyperplastic changes of ductal epithelium with or without atypia. In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Up to 66% of fibroadenomas harbor mutations in the exon (exon 2) of the mediator complex subunit 12 (MED12) gene. Mastopathic fibroadenoma of the breast: a pitfall of aspiration cytology. ; Holden, JA. and transmitted securely. Careers. A study of 11 patients. 1994 Sep;118(9):912-6. This is usual ductal hyperplasia. Jacobs. incidental finding on histologic examination), Amorphous or pleomorphic clustered microcalcifications; architectural distortion or circumscribed to spiculated mass on mammogram (, Associated with increased mammographic breast density (, Heterogeneous echogenicity, irregular and ill defined mass, focal acoustic shadowing may be seen on ultrasound (, Small (< 1 cm) mass with benign kinetics on MRI (, As a single feature, increased risk of cancer of 1.5 - 2x, as seen with proliferative, 2x higher risk of breast cancer with increased, Does not provide further risk stratification in the presence of other proliferative disease / atypical hyperplasias (, Can mimic malignancy clinically and radiologically, 46 year old woman with sclerosing adenosis with mammogram and cytology mimicking malignancy (, 73 year old woman with sclerosing adenosis and coexisting ductal carcinoma in situ (, 82 year old woman with sclerosing adenosis in sentinel axillary lymph nodes (, Presence of sclerosing adenosis alone in a core biopsy does not require surgical excision, Coexisting atypia will typically prompt surgical consultation, Variable depending on extent of involvement and calcifications, May be indistinguishable from surrounding breast tissue, Multinodular, ill defined, cuts with increased resistance due to fibrosis, Gritty due to frequent calcifications but no chalky yellow white foci or streaks as seen in, Circumscribed to ill defined white, fibrotic mass if nodular adenosis / adenosis tumor, Low power: increase in glandular elements plus stromal fibrosis / sclerosis that distorts and compresses glands, Maintains lobular architecture at low power with rounded and well defined nodules, Centrally is more cellular with distorted and compressed ductules; peripherally has more open or dilated ductules, Often has microcalcifications, due to calcification of entrapped secretions, Preservation of luminal epithelium and peripheral myoepithelium (2 cell layer) with surrounding basement membrane, Myoepithelial cells may vary from being prominent to indistinct on routine H&E staining, Myoepithelial cells are readily apparent via immunohistochemistry, even if difficult to identify on H&E, Rarely penetrates walls of blood vessels or perineural spaces, Epithelium may be involved by proliferative, atypical lesions or in situ carcinoma, If involved by atypia or in situ carcinoma, If florid and overtly non-lobulocentric / (pseudo) infiltrative into fat or stroma, Conspicuous myoepithelial cells with attenuated epithelial cells can appear like stands of single cells and mimic invasive lobular carcinoma, Atypical apocrine metaplasia: nuclear atypia / rare mitosis (, Moderate to markedly cellular, with small to large groups of benign epithelial cells in acinar sheets / cohesive groups / tubules and scattered individual epithelial cells, Also small foci of dense hyalinized stroma (, Tubules may have an angular configuration (, Fibrocystic changes including sclerosing adenosis with microcalcifications, Haphazardly distributed glands (lacks lobulocentric pattern), Lacks myoepithelium but has intact basement membrane, Nodular growth may mimic nodular adenosis / adenosis tumor, Uniform, closely packed tubules (lacks significant distortion by fibrosis), May be difficult to morphologically distinguish from florid sclerosing adenosis with marked distortion and/or involvement by atypia or, More widely spaced tubules with single epithelial layer.