The benign disorder most likely to mimic carcinoma of breast is:
a. Sclerosing adenosis is prevalent during childbearing and perimenopausal years and has no malignant potential.
b. The clinical significance of sclerosing adenosis lies in its mimicry of carcinoma. It may be confused with cancer on physical examination, by mammography also.
c. It is usually an incidental finding, may present as mammographic abnormality, microcalcifications, distorted architecture or a mass lesion, also known as nodular adenosis or adenosis tumor.
d. Excisional biopsy and histological examination are frequently necessary to exclude the diagnosis of cancer.
e. This lesion is composed of distorted epithelial, myoepithelial and sclerotic stromal elements arising in association with TDLU.
f. This lobulocentric pattern is the key to the correct diagnosis.
g. The epithelium may undergo apocrine metaplasia, when it is also known as apocrine adenosis.
h. Again the situation becomes even complicated for the histopatologist when the epithelium shows cytological atypia.
i. Perineural invasion may be present in 2% of the sclerosing adenosis cases.
j. Distorted glands are present in this lesion, which is being confused with low grade invasive carcinoma sparticularly tubular carcinoma.
k. But IHC helps to exclude tubular carcinoma as sclerosing adenosis shows myoepithelial cells on IHC.