Breast - nonmalignant
Benign tumors / changes
Gynecomastia-like changes of female breast

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 4 March 2016, last major update February 2016

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Gynecomastia-like changes [title] breast
Definition / General
  • Increased ducts and prominent stroma, histologically identical to gynecomastia of the male breast
Essential Features
  • Young patients with palpable mass lesion, typically negative mammography
  • Microscopy shows poorly circumscribed lesion with ductal hyperplasia and micropapillae, periductal fibrosis, periductal edema (similar to male gynecomastia)
  • No lobules seen
  • Often adjacent fibrocystic changes present
  • Benign, no increased risk for malignancy
Terminology
  • Also called gynecomastoid hyperplasia
Epidemiology
Clinical Features
  • Mean age 32 years, patients present with palpable mass associated with fibrocystic changes in adjacent breast
Clinical Images

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Bilateral mammograms

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1-cm noncalcified nodule

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Retroareolar mass

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Retroareolar tissue

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Enlarging asymmetric density

Micro Description
  • Poorly circumscribed areas of ductal hyperplasia with micropapillae, periductal stromal fibrosis or edema and slight lymphocytic infiltrate
  • Involves one low power field or entire core fragment of at least 1 cm, without terminal duct lobular units present (same as male gynecomastia)
  • No associated mammary hamartomatous changes, no areas of juvenile hyperplasia, no juvenile fibroadenoma
Micro Images

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Proliferation of ducts with periductal fibrosis but without lobules

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Mild lymphocytic infiltrate

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Ducts but no lobules

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Epithelial proliferations

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Myoepithelial layer

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Edematous periductal stroma

Differential Diagnosis
  • Hamartoma: sharply circumscribed, has lobules, variable smooth muscle or cartilage, no periductal stromal changes
  • Pubertal macromastia: young patients, massive involvement