Breast - nonmalignant
Benign tumors / changes
Subareolar sclerosing hyperplasia of breast

Author: Cansu Karakas, M.D. (see Authors page)

Revised: 18 February 2016, last major update February 2016

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

PubMed Search: Subareolar sclerosing hyperplasia
Definition / General
  • A sclerosing papillary variant of radial sclerosing lesion in the subareolar region, first described in 1987 (Cancer 1987;59:1927)
  • Beneath areola, without involvement of surface of nipple (called nipple adenoma if nipple is involved)
  • Note: this is the only article describing this lesion in the literature
Clinical Features
  • 26 to 73 years, mean 46 years
  • A mass located beneath the nipple or areola in the breast
  • Left and right breast affected equally
  • Erosion or ulceration of the nipple are absent
  • Nipple retraction may occur
  • Several patients had blood discharge
  • Nonspecific mammographic findings, may mimic carcinoma
Treatment
  • Excision through circumareolar incision, sparing the nipple
  • Recurrence may occur after incomplete excision
  • Benign, no evidence that this condition is premalignant
Gross Description
  • Firm to hard, round to oval tumor with indistinct margins
  • Mean 1.2 cm, range 0.6 to 2.0 cm
  • Yellow streaks may be noted
Micro Description
  • Prominent central elastosis and sclerosis in the center of the tumor, duct hyperplasia is more prominent in the periphery, causing distortion of the ductal pattern
  • Cartilaginous metaplasia may occur in the sclerotic core
  • Varying amounts of papillary ductal proliferation
  • Papillary epithelial hyperplasia within ducts may exhibit considerable atypia
  • Generally no cystic change, no papilary apocrine change, no squamous metaplasia
Micro Images

Images hosted on PathOut server:

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Papillary duct proliferation

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Solid foci in ducts

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Papillary duct hyperplasia

Differential Diagnosis