6- Intraductal papillomas Benign breast lesions affecting the lactiferous ducts, but smaller peripheral ducts may also be involved; they’re wart-like growths of gland tissue with fibrous tissue and blood vessels (fibrovascular tissue). Papillomas may be solitary or multiple. Solitary papillomas: the commonest; are single tumors that usually occur centrally in subareolar ducts, they are a common cause of clear or bloody nipple discharge, may be felt as a small lump behind the nipple.
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Multiple papillomas: likely to be peripheral and involve terminal duct lobular units, found in small ducts in areas of the breast farther from the nipple, less likely to cause nipple discharge and usually bilateral. (37)
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Epithelial component consist of cuboidal to columnar cells without pleomorphism, nuclear atypia or mitotic figures. (34)
Fig.7. Papilloma. The epithelial cells are laying on fibrovascular core showing no atypia, H & E, x100 and x400. (38) 7- Granular cell tumors They are never cancers, start in primitive nerve cells, rarely found in the breast, can be felt as a firm mobile lump, but some may be attached to the skin or chest wall, they are usually about ½ to 1 inch across and most often are in the upper, inner part of the breast. (39)
Fig.8. Granular cell tumor shows a well circumscribed tumor with lobular nested architecture. High power shows nests of cells with small nuclei and abundant granular eosinophilic cytoplasm. (40)
8- Duct
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Duct ectasia. (42) 9- Fibroadenoma The most common benign breast tumor, made up of both glandular breast tissue and stromal tissue. Mostly occurs in second and third decade of life, but can be found in women of any age. (5)
Grossly: fibroadenomas are nodular, rubbery tumors, they vary in size from less than 1 cm up to 10-15cm in diameter has borders that are distinct from the surrounding breast tissue, and they are easily separated from the surrounding breast tissue. (25)
Histologically: fibroadenoma is composing of epithelial and stromal components; the epithelial part is made up of tubules consisting of cuboidal to low columnar cells, resting on a myoepithelial cell layer.
And cellular fibroblastic stromas which contain loose connective tissue, the stromal cells are small, spaced; they show no cytologic atypia and little or no mitotic activity. (41)
Complex fibroadenoma is called when there is morphologic variation as hyalinization, mixoid change, calcification, apocrine metaplasia and sclerosing adenosis.
Malignant transformation in fibroadenoma rarely occurs, usually involving the epithelial component in the form of carcinoma in situ and invasive carcinoma (lobular and