Common Benign Breast Lesions Research Articles

Cytomorphological Pattern of Neoplastic and Non-Neoplastic Breast Lesions - An Institutional Experience of a Rural Tertiary Care Center

BACKGROUND
 Among Indian population, benign as well as malignant breast lesions are quite common. Fine needle aspiration cytology (FNAC) is frequently carried out as it is a simple, safe, reliable and time saving procedure. A short retrospective study was designed to evaluate the role of fine needle aspiration cytology (FNAC) & frequency of palpable breast lesions/lumps. Early diagnosis of breast lesions through FNAC prompts early treatment without the need for biopsy. The purpose of this study was to analyse the cytomorphological patterns of non-neoplastic and neoplastic lesions diagnosed by FNAC over a time period at a tertiary care hospital.
 METHODS
 This retrospective observational study was conducted as a hospital opd based procedure from June 2019 to December 2019. A total of 210 patients having breast lesions/lumps were included, among which 5 patients were excluded because of unsatisfactory FNAC aspirate. Smears were processed and their cytological evaluation was done by experienced pathologists.
 RESULTS
 Among all breast lesions, non-neoplastic was most commonly seen in 2nd decade of life and neoplastic in 5th decade of life. Fibroadenoma was the most common benign breast lesion followed by fibrocystic disease while among neoplastic lesions invasive ductal carcinoma was most common. Involvement of left breast was most common.
 CONCLUSIONS
 Benign breast diseases are quite common in younger population. Fibroadenoma is the most common benign condition among females of reporductive age group. FNAC is routinely done to separate malignant lesions from benign ones which makes it an important tool in guiding further management as it is a quick, simple, feasible, and cost-effective method.

In Search of Calcifications : Histologic Analysis and Diagnostic Yield of Stereotactic Core Needle Breast Biopsies.

Stereotactic core needle biopsy (SCNB) is used in the diagnostic assessment of suspicious mammographic calcifications to rule out breast ductal carcinoma in situ (DCIS). With advances in imaging technology and increased biopsy tissue volume, the detection rate of calcifications and DCIS in SCNB is unclear. This retrospective study included 916 consecutive SCNBs for calcifications performed on 893 patients in a 2-year period. We found the cancer detection rate was 27.1% (DCIS, 23.7%; invasive, 3.4%). The detection rate for calcifications was 74.8% with the standard 3 levels. Additional leveling of calcification-negative cases further increased the detection of both calcifications (to 99.4% of cases) and DCIS (to 32.9% of cases). Lobular neoplasia (LN) was diagnosed in 41 cases. Twenty-five (61.0%) cases of LN were incidental without associated calcification. Of 32 invasive carcinomas detected on SCNB, 87.5% were T1a or less, and calcifications were associated with atypical ductal hyperplasia/DCIS or LCIS. The common benign lesions associated with calcifications were fibrocystic change (32.5%), fibroadenomatous change (30.2%), and columnar cell change and hyperplasia (8.2%). We determined the up-to-date detection rates of calcification and DCIS in SCNB, as well as the common benign and malignant breast lesions associated with calcifications. Additional levels significantly increase the detection rate when standard levels show only stromal or scant/absent calcifications. Lobular neoplasia is often an incidental finding in SCNB for calcifications. When calcifications are present with LN, they are commonly florid, pleomorphic LCIS, or with concurrent invasive carcinoma.

Prevalence, Impact, and Diagnostic Challenges of Benign Breast Disease: A Narrative Review.

Benign breast diseases, which are commonly seen in clinical practice, have various clinical presentations and implications, as well as management strategies. This article describes common benign breast lesions, presentations of these lesions, and typical radiographic and histologic findings. Also included in this review are the most recent data and guideline-based recommendations for the management of benign breast diseases at diagnosis, including surgical referral, medical management, and ongoing surveillance.

Evaluation of Benign Breast Diseases With or Without Atypical Epithelial Hyperplasia Accompanying Radial Scars.

A radial scar (RS) is a benign breast lesion (BBL) that has an obscure etiology. RS is easily confused with breast carcinoma and therefore correct identification radiologically and pathologically is important. The aim of this study was to determine the incidence of atypical lesions by evaluating RS detected with BBL and to investigate whether atypia and RS are related to their characteristics. A total of 1.370 patients with a diagnosis of BBL postoperatively in a single department were analyzed retrospectively. Forty-six confirmed RS/complex sclerosing lesion (CSL) cases were selected. The demographic and clinical characteristics of the patients and the relationship between RS and other BBL were evaluated. In addition, the relationship between RS/CSL and the presence of atypia was interpreted. The mean age was 45.17±8.72 years. Spiculated lesion (34.8%) on mammography and microcalcification (37%) on histopathological examination were the most common features. The most common BBL accompanying RS/CSL was adenosis. Atypical epithelial hyperplasia (AEH) was presented in 15 (32.6%) of those diagnosed with RS. Although all patients were benign, the frequency of AEH accompanying RS was found to be significantly higher. The mean size of RS was 10.8±8.4 mm (2-30 mm). The size of RS/CSL was not significantly associated with atypia. RS/CSLs usually present as suspicious lesions that must be distinguished radiologically from malignancy. However RS, which can be present with malign breast lesions, can be also seen with all BBL. Therefore, core biopsy and/or excisional biopsy continue to be important for definitive histopathological diagnosis.

When Friend Becomes Foe: Complications of Fibroadenoma Imaging Spectrum

AbstractFibroadenoma are the most common benign breast lesions. Complications in fibroadenoma although rare in occurrence, are reported. It is important to be aware of the possible complications, both benign and malignant which may require surgical management. Commonly encountered benign complications in a fibroadenoma are infarction, rapid increase in size, and lactational changes. A common differential of a giant fibroadenoma is phyllodes tumor which has subtle imaging differences. Malignant transformation of a fibroadenoma is very rare although cases are reported (0.02%). Breast is a dynamic organ and is influenced by the hormone surges occurring typically during pregnancy and lactation, it causes changes in morphology of prior existing fibroadenoma which may mimic like a malignancy and hence knowledge of these benign complications in a fibroadenoma is also important. To identify the subtle radiologic imaging features which may suggest complication developing in a known fibroadenoma, prompting for a histopathological examination correlation. In this article, we discuss the imaging features of complications in a fibroadenoma—benign and malignant. Sinister etiology secondarily engulfing a fibroadenoma and sinister focus developing in a fibroadenoma will be discussed. Also, the benign complications in a fibroadenoma like lactational changes, spontaneous infarction within a fibroadenoma, and excessive increase in the size of fibroadenoma with degenerative changes due to the estrogen and progesterone effect which can mimic like a malignancy will be illustrated. A careful history, meticulous scanning, close monitoring, and histopathological correlation is invaluable to identify these complications in a known fibroadenoma and thus guide in the appropriate management of these lesions.

Histopathologic metrics of breast tumors in Northern Saudi Arabia

The alarming liability of breast cancer, mainly among younger Saudi women, has been attributed to diverse factors requiring a manageable valuation. Therefore, this study aimed to assess the types of tumors and breast cancer presentation stages in Northern Saudi Arabia. In the present study, retrieved data regarding breast biopsies were received from the Department of Pathology at King Salman Hospital, Hail, Northern Saudi Arabia. Included data referring to breast cancer biopsies patients (including 131 females and two males) diagnosed during the period from November 2019 to November 2020. Out of the 133 patients, breast cancer was diagnosed in 49/133(36.8%) patients included 45/49(91.8%) invasive ductal carcinoma (IDC), 2/49(4.1%) invasive lobular carcinoma (ILC), and 2/49(4.1%) papillary carcinoma. The remaining 84 benign breast lesions included 40/84(47.6%) fibroadenoma, 11/84(13%) ductal hyperplasia, 9/84(10.7%) fibrocystic disease, 8/84(9.5%) adenosis, 4/84(4.8%) chronic mastitis, 3/84(3.6%) breast abscess & intraductal papilloma, 2/84(2.4%) duct ectasia & phylloides tumor, and 1/84(1.2%) lactating adenoma & lipoma. Breast cancer is highly prevalent in Northern Saudi Arabia with predominantly invasive ductal carcinoma. There is an increase in the incidence of younger patients with advanced stages of initial presentation. Fibroadenoma is the commonest benign breast lesion, followed by fibrocystic diseases in Northern Saudi Arabia.

Vacuum-Assisted Excision, Scarless Solution for Fibroadenoma Breast-A Single-Center Experience.

Background Fibroadenoma is one of the most common benign breast lesions that is frequently surgically excised in breast practice. Aim The aim of this study was to determine the efficacy and safety of ultrasound-guided (USG) vacuum-assisted excision biopsy (VAEB) of fibroadenoma. Settings and Design A retrospective observational study. Methods and Materials A total of 113 patients with 163 fibroadenomas who underwent USG-guided VAEB under local anesthesia with 7G and 10G probes using an Encor Enspire equipment were included in the study. The patients were followed up after 1, 6, and 12 months. The fibroadenomas up to 4 cm were excised as per the U.S. Food and Drug Administration-approved guidelines of the American Society of Surgeons for percutaneous removal of benign breast lesions. Results The percentage of complete excision rate was 98.8% and the most frequent complication encountered was hematoma including immediate and delayed accounting for 3.06%. There were no recurrent lesions in our study. Conclusion USG-guided VAEB of benign breast lumps can be a safe and effective alternative to surgical excision and had better patient satisfaction in terms of efficacy and cosmesis.

Fibroadenoma gigante juvenil y cirugía de reconstrucción: reporte de un caso y revisión de la bibliografía

Fibroadenoma is the most common benign breast lesion in young women, being the giant juvenile fibroadenoma an entity that appears mainly in those under 25 years. With an etiology currently not well established, it is described as a mass type lesion greater than 5cm or that occupies more than 80% of the breast and presents significant growth, with the physical and psychological consequences that this entails. Despite being a benign lesion, its fast evolution and growth makes it necessary to rule out malignancy, which occurs in less than 0.2% of the cases. The diagnosis is based on a correct anamnesis, physical examination and complementary tests, preferable with ultrasound. The anatomopathological study by biopsy allows to confirm the clinical diagnosis of benignity or to rule out malignancy in the event of a suspicious evolution. Its management is surgical and consists of complete excision of the lesion, varying the surgical technique performed (from conservative surgery to mastectomy with reconstruction) according to the size of the lesion, the characteristics of the breast, and the age of the patient.

Effects of the oral probiotics to control pain and stress disorders of cyclical mastalgia associated with fibrocystic breast changes; a randomised controlled trial

BackgroundBreast fibrocystic changes (FCC) is the most common benign breast lesion among females in productive age. Cyclical pain is the most common symptom of the lesion which decreases life quality and worsens stress disorders of sufferers. The study aimed to evaluate effects of oral probiotics to confront such pain and stress among females. MethodIn this randomised, double-blind controlled trial finally 50 eligible women with cyclical mastalgia due to the FCC aged between 18 and 40 years were enrolled. They were allocated in placebo and probiotic receivers. Subjects in the latter received a daily capsule containing of 2 × 109 colony forming units of probiotic microorganisms. Patients underwent a 12 weeks survey. The Visual analog scaling instrument was applied to measure pain severity. Blood samples were sent to evaluate hs-CRP, total antioxidant capacity (TAC), malondialdehyde and total plasma gluthation. Stress disorders including of depression, anxiety and sleep quality also were investigated by standard relative questionnaires. ResultsProbiotic receivers showed meaningful decrease in cyclical mastalgia (p < 0.01) after 12 weeks probiotic consumption. Additionally plasma level of hs-CRP (p = 0.03) decreased concurrently with significant increase in TAC (p = 0.04) level among probiotic receivers. Probiotics helped better recovery from depressive symptoms although influenced positively neither anxiety nor sleep quality. ConclusionThis study showed that oral probiotic consumption should be considered to control the pain in cyclical mastalgia contributing to FCC of the breast.

Clinico-pathological spectrum of breast lesions in females over a period of three years in a tertiary care centre

Aim: The aim of this study is to evaluate the clinic-pathological spectrum of breast biopsies for a period of three years. Materials and Methods: This study includes 529 breast pathology cases received by histopathology laboratories of Department of pathology, Government Medical College, Srinagar between January 2017 to January December 2019. The samples included mastectomies, lumpectomies, core needle biopsy and tru cut biopsy specimens. Results: In the present study, out of 529 cases there were 56 (10.58%) inflammatory lesions, 287 (54.2%) benign lesions and 186 (35.16%) malignant lesions. Fibroadenoma was the most common benign breast lesion. Among the malignant breast lesions, infiltrating duct cell carcinoma was the most common. Conclusion: The pattern of breast lesions observed showed higher prevelance of non-malignant breast lesions over malignant lesions. Awareness and screening of these entities can facilitate early diagnosis and management.

Role of Dynamic Contrast Enhanced Magnetic Resonance Imaging and Mammogram in Evaluation of Breast Lesions with Pathological Correlation

Background: To perform mammography and dynamic contrast enhanced MRI in patients with clinically suspicious breast lumps and correlating the findings with pathology in patients of positive imaging. Subjects and Methods: total of 40 patients evaluated through MRI BI-RADS lexicon (General Electric Medical Systems) at 1.5T in combination with dynamic kinetic analysis of time and signal curves for lesion characterization. Results: The mean age was 44 years, maximum of patients (n=22) belongs to age group of 41-60 years (52.5%). Five lesions showed dark internal septations, as benign. 11 lesions (33.5%) showed heterogenous enhancement, as malignant. Early rim enhancement is observed in 3 lesions (9%). Out of which two of them were proven to be malignant and one lesion was an infective abscess. Invasive Duct Cell Carcinoma was the common histology in the malignant lesions, observed in 13 out of 18 (72.2%). Fibroadenoma was the common benign breast lesion, observed in 8 out of 19 (42.1%). In 4 post operative patients, 2 (50%) were post operative fibrosis, 1 (25%) was recurrence and 1 (25%) was post operative collection. In 18 malignant lesions, 11 patients (61.1%) had skin retraction, 10 patients (55.5%) had skin thickening, 9 patients (50%) had axillary lymphadenopathy, 2 patients (11.1%) had nipple retraction, and one patient (5.6%) had pectoralis involvement. In our study, MR imaging alone has Sensitivity of 88.8%, specificity of 86.3%, PPV of 84.2%, and NPV of 90.4% with Accuracy 87.5%. Conclusion : The dynamic contrast enhanced MRI is important tool to evaluate the postoperative breast in differentiating between benign postoperative changes. By combining kinetic analysis with morphological analysis it add benefit to categorise the breast lesions into benign and malignant with increased confidence levels. CE-MRI with both morphology and kinetic curve assessment has a Sensitivity of 94.5%, Specificity of 100% with Accuracy of 97.5%.

Correlation of FNAC with Histopathology of breast lesions

Breast cancer is a commonest maliganancy of women globally. A papable breast lump is common diagnostic dilemma to surgeons. Fine needle aspiration cytology (FNAC) is simple rapid, accurate diagnostic tool for evaluating palpable breast lumps. Mammography is other screening modality for a breast lump which is routinely used method with simple, low cost with high accuracy.To differentiate and categories the breast lesions, and to study the correlation of FNAC with histopathology of palpable breast lumps.one and half year retrospective study carried out from January 2019 to June 2020 in the department of pathology, KBNIMS, Gulbarga. FNAC and Histopathology slides were retrieved and reviewed. All the slides were observed and findings recorded. Mammography findings were retrieved and recorded.The present study includes 125 cases out of which 101 cases (80.8%) were benign and 24 cases (19.2%) were malignant. Most common benign breast lesion was fibroadenoma (52.4%) and malignant lesion was infiltrating ductal carcinoma (75%). Frequencies of left breast lesions were high compare to right breast lesions. Out of 125 cases FNAC, 123 cases (98.4%) correlated with histopathology with sensitivity of 91.66%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 98% and accuracy of 98.4%.Out of 125 cases, mammography of 25 cases were retrieved with sensitivity of 87.5% and specificity of 94.11% with diagnostic accuracy of 92%.FNAC is a valuable diagnostic tool; provide rapid and reliable diagnosis in breast lesions.

Rapid and Accurate Visualization of Breast Tumors with a Fluorescent Probe Targeting α-Mannosidase 2C1.

Accurate detection of breast tumors and discrimination of tumor from normal tissues during breast-conserving surgery are essential to reduce the risk of misdiagnosis or recurrence. However, existing probes show substantial background signals in normal breast tissues. In this study, we focus on glycosidase activities in breast tumors. We synthesized a series of 12 fluorescent probes and performed imaging-based evaluation on surgically resected human breast specimens. Among them, the α-mannosidase-reactive fluorescent probe HMRef-αMan detected breast cancer with 90% sensitivity and 100% specificity. We identified α-mannosidase 2C1 as the target enzyme and confirmed its overexpression in various breast tumors. We found that fibroadenoma, the most common benign breast lesion in young woman, tends to have higher α-mannosidase 2C1 activity than malignant cancer. Combined application of green-emitting HMRef-αMan and a red-emitting γ-glutamyltranspeptidase probe enabled efficient dual-color, dual-target optical discrimination of malignant and benign tumors.

Unusual Presentation of Benign Breast Disease in an Adolescent Girl

Fibroadenomas are the most common benign breast lesions in adolescents. Fibroadenomas larger than 5 cm, weighing more than 500 g, or replacing at least 80% of the breast are termed giant fibroadenomas. Giant fibroadenomas usually warrant surgical excision as they alter the normal breast architecture. We report a case of probably the largest described bilateral juvenile giant fibroadenomas in a young 12-year-old girl managed with subcutaneous mastectomy and free nipple areola complex full thickness graft. The case highlights the rarity of disease presentation and difficulty in decision-making in selecting the best surgical option for such patients.

Study of Histopathological Patterns in Breast Lumps

Background: Breast lesions in females are heterogeneous diseases that consist of several distinct entities with remarkably different characteristic features. The present study was conducted to assess histopathological findings of excision biopsies of breast lesions.Subjects and Methods:The present study was conducted on 150 cases of lumpectomy breast specimens received in the department of histopathology. The histopathological diagnosis made after routine processing and hematoxlin and eosin staining.Results:The most common age group of presentation was 30 to 50 years having well defined breast mass lesion. The difference was significant (P&lt; 0.05). Among 150 breast specimens, 145 found to be benign and 05 malignant. In benign, common lesions were fibroadenoma in 64, fibroadenosis in 30, Acute Suppurativeinflammatory lesion (Abscess) in 20, fibrocystic disease (FCD) in 22, duct papilloma in 05 and benign phyllodes in 04 cases. In malignant, 04 cases were infiltrative ductal cell carcinoma NOS (Not otherwise specified) and 01 carcinoma in situ. The difference was significant (P&lt; 0.05).Conclusion: Authors found that most common benign breast lesions were fibroadenoma (44.1%) and fibroadenosis (20.6%) followed by acute suppurative inflammatory (Abscess) and FCD.

Breast Cytology and Pathology in Pregnancy and Lactation.

Breast tissue reveals some physiologic changes during pregnancy and lactation due to hormonal alterations. Whole range of breast diseases including inflammatory, benign and malignant neoplasms can be seen in pregnancy but due to concurrent physiologic changes, may lead to diagnostic challenges. This chapter reviews sampling methodsand histologic features of common benign breast lesions in pregnancy and lactation periods.

A study of histopathological spectrum of breast lesions in a tertiary care hospital

Background: Various types of pathologies from inflammation to carcinoma are known to affect breast tissue in females. Some lesions are common in young females while others are more common in elderly age group. Accurate diagnosis is essential to relieve anxiety of patients. In case of carcinoma, early and accurate diagnosis can save the patient from metastases, thus reducing mortality and morbidity. Aims and objectives: This study is aimed to analyse the histopathological spectrum of various breast lesions and to study the distribution of breast diseases in different age groups and gender in our institute. Materials and Methods: It is a prospective study performed in the Department of pathology at Government Medical College/Government General Hospital Anantapuramu over a period of four years from January 2015 to December 2018. During this period a total of 310 breast specimens were received in the Department of pathology. Histopathological examination of specimens was done to know the spectrum of breast lesions. Results: Out of 310cases, 290cases were female and 20 cases were male. 185 cases were benign breast neoplasms, 123 cases were malignant neoplasms and 02 cases were inflammatory lesions. Among the 185 cases of benign breast neoplasms, 141 cases were fibroadenoma which was the most common benign breast lesion. Out of 123 malignant breast lesions, 2 cases were Duct cell carcinoma in situ and 121 cases were invasive malignant breast lesions. Out of which 97 cases were Invasive ductal carcinoma –NOS subtype which was the most common lesion. Conclusion: 59.68% of breast lesions were benign breast lesions proving to be the majority in incidence. 39.68 % of lesions were malignant breast lesions and 0.64% were inflammatory lesions. Benign lesions were common in second to fourth decade and malignancy in fifth and sixth decades.

Histopathological spectrum of neoplastic and non-neoplastic lesions of breast in a tertiary care centre in Bangalore

Introduction: Breast lesions are a broad spectrum of lesions consisting of several distinct entities each with specific characteristics. Early evaluation of lesions with timely accurate diagnosis can alleviate anxiety of patients and also can be lifesaving. The most common cancer among Indian women is Breast cancer accounting to 25.8 per 100,000 women. Materials and Methods: A total of 100 cases of neoplastic and non-neoplastic lesions of breast were evaluated from June 2015 to June 2018 which were sent to department of pathology, Dr B R Ambedkar Medical College, Bangalore, Karnataka. Specimens were fixed in formalin of 10%. Appropriate areas were selected from the specimen and grossed, processed, sectioned, stained using haematoxylin and eosin and were observed under microscope. Results: out of 100 resected specimens, 19 cases were non-neoplastic, 46 were benign, and 35 cases were malignant. The most common benign breast lesion was Fibroadenoma (31%) and the most common malignant breast lesion was invasive carcinoma- No Special type (22%). Conclusion: Histopathological evaluation helps in distinguishing benign, insitu, borderline and malignant breast lesions and is the mainstay of accurate and confirmatory diagnosis. This helps in evaluating the risk of patient in developing cancer and appropriate treatment can be planned accordingly for each case. Keywords: Histopathology breast, Benign breast, Malignant breast lesions, Fibroadenoma, Invasive carcinoma.

Breast fibroadenomas are not associated with increased breast cancer risk in an African American contemporary cohort of women with benign breast disease

BackgroundFibroadenomas are common benign breast lesions, and studies of European American women indicate a persistent, increased risk of breast cancer after diagnosing a fibroadenoma on biopsy. This association has not been independently assessed in African American women, despite reports that these women are more likely to present with fibroadenomas.MethodsThe study cohort included 3853 African American women with a breast biopsy completed between 1997 and 2010 in metropolitan Detroit. Biopsies were microscopically reviewed for benign breast lesions, including fibroadenoma, proliferative disease, and atypia. Risk of breast cancer within the cohort was estimated using relative risk ratios and 95% CIs calculated using multivariable log-binomial regression. Relative risk of breast cancer in this cohort compared with African American women in the broader metropolitan Detroit population was estimated using standardized incidence ratios (SIRs).ResultsFibroadenomas occurred more frequently in biopsies of younger women, and other types of benign breast lesions were less likely to occur when a fibroadenoma was present (p = 0.008 for lobular hyperplasia; all other p values < 0.01). Unlike women with other benign lesions (SIR, 1.41; 95% CI, 1.20, 1.66), women with fibroadenomas did not have an increased risk of developing breast cancer compared with the general population (SIR, 0.94; 95% CI, 0.75, 1.18). Biopsies that indicated a fibroadenoma were associated with a reduced risk of breast cancer after adjusting for age at biopsy, proliferation, and atypia (relative risk, 0.67; 95% CI, 0.48, 0.93) compared with biopsies without a fibroadenoma.ConclusionsThese findings have important implications for breast cancer risk models and clinical assessment, particularly among African American women, in whom fibroadenomas are common.

Expression of c-kit in common benign and malignant breast lesions.

c-kit (CD117) is a transmembrane tyrosine kinase that acts as a type III receptor for mast cell growth factor. In recent years, the role of c-kit in the development of preinvasive and invasive breast carcinomas has been investigated. The aim of our study was to detect c-kit expression in the entire spectrum of common benign and malignant breast lesions in correlation with a well-studied myoepithelial or stem-cell like marker (p63). We evaluated 270 cases of benign and malignant breast lesions including fibrocystic disease, fibroadenoma, sclerosing adenosis, atypical ductal hyperplasia, ductal/lobular carcinoma in situ, and ductal/lobular/mixed type carcinoma. C-kit staining was evaluated in the cytoplasm/cell membrane in epithelial and myoepithelial cells and p63 in the nuclei of myoepithelial cells. c-kit was highly expressed (85.3%) in benign lesions (fibrocystic disease, sclerosing adenosis, fibroadenoma), and p63 expression was 95.5% in the aforementioned lesions. c-kit distribution in preinvasive and invasive lesions was as follows: ductal/lobular carcinoma in-situ, 43%/35%; ductal/lobular carcinoma, 36%/39%; and mixed type carcinoma, 20%. c-kit was highly expressed in myofibroblast/fibroblast cells only in grade III ductal/lobular carcinomas. c-kit was totally absent in stromal cells in benign lesions and in situ carcinomas whereas expression was weak in grade I and II carcinomas. Combined overexpression of c-kit and p63 is indicative of benign breast lesions. In contrast, there is reduced expression of c-kit in in situ and invasive breast carcinomas, with simultaneous overexpression in the stromal cells. This suggests that c-kit may play a role in breast cancer progression.