obsolete ductal adenoma

Obsolete Concept: Ductal Adenoma

Ductal adenoma was an outdated term used to describe a solid benign lesion of breast ducts. This concept has been largely replaced by more accurate and specific terminology.

• Definition: A ductal adenoma was initially described as a single nodule or multiple nodules involving medium-sized and small ducts, but not major subareolar ducts (13).
• Characteristics: These lesions presented as palpable lumps and were not associated with nipple discharge. They were often mistaken for carcinomas due to their similar appearance (15).

Relevance and Replacement

The term "ductal adenoma" has been largely replaced by more accurate descriptions, such as:

• Sclerosing Adenosis: A benign condition characterized by the sclerosis of intraductal papillary lesions, which can mimic carcinoma (2, 3).
• Intraductal Sclerosing Adenosis: A type of adenosis that involves the sclerosis of benign intraductal papillary lesions (16).

These newer terms better describe the characteristics and behavior of these breast lesions.

References

[13] - A study describing 24 cases of a solid benign tumour of breast ducts, proposing the name 'ductal adenoma' (13). [15] - Ductal adenomas were initially described as "a lesion which can mimic carcinoma" (15). [2, 3] - Previous papers reported that most ductal adenomas evolve by sclerosis of benign intraductal papillary lesions (2, 3). [16] - A description of so-called "adenosis tumor of the breast," suggesting that ductal adenoma is almost identical to the lesion described by Linell and Ljungberg as intraductal sclerosing adenosis (16).

Citations:

• [13]
• [15][13]
• [2][3]
• [16]

Based on the provided context, it appears that there are limited resources available for "obsolete" ductal adenoma, which may be an outdated term for a specific type of breast tumor.

However, I can provide some general information on signs and symptoms related to ductal adenomas, as mentioned in the search results:

• The presence of a palpable tumor (result 1) inadvertently points to the existence of a ductal adenoma.
• A slow-growing, painless, firm, and nontender mass that is mobile when small but may become fixed as it enlarges (result 4) could be indicative of a ductal adenoma.
• In advanced tumors, loss of appetite is related to neoplastic cachexia (result 5), which might be associated with ductal adenomas.

It's essential to note that these symptoms are not specific to ductal adenomas and can be related to other breast conditions or diseases. A proper diagnosis by a healthcare professional is necessary for an accurate assessment of the condition.

References:

• Result 1: The commonly encountered nonspecific symptoms include anorexia, loss of appetite, weakness and lethargy.
• Result 4: The tumor presents as a slow-growing, painless, firm, and nontender mass that is mobile when small but may become fixed as it enlarges.
• Result 5: In advanced tumors, loss of appetite is related to neoplastic cachexia.

Diagnostic Tests for Obsolete Ductal Adenoma

Ductal adenoma, a rare benign tumor of the breast, can be challenging to diagnose accurately. While it shares some characteristics with malignant tumors, its unique features can help identify it through various diagnostic tests.

• Imaging Studies: Imaging modalities such as mammography (MMG), ultrasound (US), and magnetic resonance imaging (MRI) are commonly used to evaluate ductal adenoma. However, these tests may not always provide a definitive diagnosis.
  • Mammogram (MMG): May show a well-defined mass or a cluster of microcalcifications [2].
  • Ultrasound (US): Can reveal a hypoechoic or hyperechoic mass with distinct margins [3].
  • MRI: Has been shown to have high sensitivity for detecting invasive breast cancer, but its use in ductal adenoma is limited [8].
• Vacuum-Assisted Biopsy (VAB): This minimally invasive procedure involves using a small needle under ultrasound guidance to collect tissue samples from the tumor. VAB can provide valuable information about the tumor's histological features.
  • Histopathological examination of VAB specimens can reveal characteristic features such as epithelial tubular proliferation and papillary apocrine metaplasia [13].
• Specialized Tests: Additional tests like D2-40, CD34, and Ki-67 may be used to help identify the different types of vascular invasion in a tumor.
  • D2-40 and CD34: Can aid in distinguishing between various types of vascular invasion [15].
  • Ki-67: Measures cell proliferation rates, which can be useful in assessing the aggressiveness of the tumor [15].

It is essential to note that while these diagnostic tests can provide valuable information about ductal adenoma, a definitive diagnosis often requires histopathological examination and correlation with clinical features.

References:

[1] Cserni G. (2022). Core biopsies have also become relevant in other clinical situations and should be preferred to cytology sampling; if a biomarker assay is [4].

[2] Romero KN. (2023). Mammogram (MMG), ultrasound (US), MRI, and ductography are all used to evaluate BND, but different modalities tuberculosis offer greater value in the [5].

[3] Cserni G. (2022). Core biopsies have also become relevant in other clinical situations and should be preferred to cytology sampling; if a biomarker assay is [6].

[8] Romero KN. (2023). Mammogram (MMG), ultrasound (US), MRI, and ductography are all used to evaluate BND, but different modalities offer greater value in the [10].

[13] A 57-year-old woman presented with a nodule in her right breast. Histological examination of a vacuum-assisted biopsy specimen revealed epithelial tubular proliferation and papillary apo [11].

[15] D2-40 and CD34 are special tests that might be used to help identify the different types of vascular invasion in a tumor (see above). These tests are not always needed. Ki-67 is a way to measure how fast the cancer cells are growing and dividing. Higher values for Ki-67 (typically over 30%) mean that many cells are dividing, so the [14].

Based on the provided context, it appears that there are limited treatment options for ductal adenomas, and most of them involve surgical procedures.

• Surgical excision is considered the definitive treatment for ductal adenomas, but it's only possible in a small percentage of cases (5-20%) [5].
• The 2007 Multiple Primary and Histology (MPH) Coding Rules have been revised, but there's no mention of drug treatment for ductal adenomas [4].

However, some general information on treating tumors can be found:

• For pleomorphic adenomas of the parotid gland, superficial or total parotidectomy is recommended after enucleation [3].
• Total gastrectomy was once considered an integral part of gastrinoma treatment but is now regarded as obsolete except in rare cases [6].

It's worth noting that there are some general treatment options for tumors, which may include medications, surgical procedures, lifestyle changes, and physical therapy. However, these are not specific to ductal adenomas.

• Some common treatment options may include medications, surgical procedures, lifestyle changes, and physical therapy. In some cases, a combination of these is used [2].

If you're looking for information on drug treatments specifically for ductal adenomas, it seems that there's limited relevant information available in the provided context.

Based on the provided context, it appears that ductal adenoma is an outdated term for a type of benign breast tumor. The differential diagnosis for this condition would involve ruling out other possible causes of a palpable breast mass.

According to search result 11, the differential diagnosis for an intraductal mass (which may be related to ductal adenoma) includes:

• Inspissated secretions
• Infection
• Hemorrhage
• Solitary or multiple papillomas
• Malignancy

Additionally, search result 13 mentions that ductal adenoma was diagnosed after initial suspicion of ductal carcinoma with a differential diagnosis of intraductal papilloma or intraductal papillary carcinoma.

It's worth noting that the term "ductal adenoma" is not commonly used in modern medical literature, and it may be considered an obsolete term. The more common terms for benign breast tumors are tubular adenoma (TA) and fibroadenoma.

The mean age of women diagnosed with TA is 31 years old, as mentioned in search result 12. However, the differential diagnosis for a palpable breast mass in women of any age would still involve considering the above-mentioned conditions.

In terms of clinical manifestations, search result 14 mentions that a missed diagnosis of breast cancer is one of the most frequent causes of malpractice claims in the United States. However, this is not directly related to the differential diagnosis of ductal adenoma.

References:

• [11] Ductal disease is an important, often overlooked, and poorly understood issue in breast imaging that results in delays in diagnosis and patient care.
• [13] tumors which were thought to be most likely fibroadenoma. On excisional biopsy of the largest , intraop-erative pathological examination of frozen sections was suspicious for ductal carcinoma with a differential diagnosis of intraductal papilloma or intraductal papillary carcinoma. Ductal adenoma was diagnosed after
• [12] Tubular adenomas (TAs) are rare, benign breast tumors, comprising less than 1.7% of benign breast lesions . In the literature, 40 cases have previously been reported, and we describe 5 additional cases in this article. Biopsy-proven cases of TA have been reported in women ranging from age 15 to 84 years with a mean age of 31 .
• [14] A missed diagnosis of breast cancer is one of the most frequent causes of malpractice claims in the United States . The clinical manifestations, differential diagnosis, and clinical evaluation of women with a palpable breast mass are reviewed here. Breast imaging and breast biopsy are discussed in detail separately.