Adenosis is a benign, non-cancerous condition characterized by an abnormal increase in the number and size of glandular components within an organ. While it can occur in various parts of the body, it is most frequently identified in the breast. It represents a microscopic change in tissue structure.
What is Adenosis?
Adenosis refers to a group of benign breast lesions marked by an increased number of mammary glandular units, specifically enlarged lobules and terminal ductal lobular units. This proliferation involves an increased number of ductules and acini within the lobule.
Sclerosing adenosis is a common form of breast adenosis where enlarged lobules are distorted by scar-like tissue. This type can sometimes present as a palpable mass or a suspicious finding on mammography, often appearing as microcalcifications. Blunt duct adenosis involves an increase in the number of ducts, which can also contain calcium phosphate microcalcifications. Microglandular adenosis is another type characterized by a haphazard proliferation of glands.
How is Adenosis Diagnosed?
Adenosis is frequently discovered incidentally during breast imaging examinations, such as mammograms, ultrasounds, or MRIs, performed to investigate other concerns or as part of routine screening. On a mammogram, adenosis might appear as a solid mass, an area of architectural distortion, or a cluster of white spots or flecks, known as calcifications. These calcifications can sometimes make it difficult to distinguish adenosis from cancerous lesions based on imaging alone.
When imaging tests identify suspicious areas, a biopsy is typically performed to obtain tissue samples for definitive diagnosis. Common biopsy methods include core needle biopsy, which removes small tissue cylinders, or excisional biopsy, which involves surgical removal of the entire suspicious area. A pathologist then examines the tissue under a microscope to confirm the presence of adenosis and rule out malignancy by looking for specific cellular arrangements and the absence of cancerous cells. Core needle biopsy is often the first step.
Understanding the Implications of an Adenosis Diagnosis
An adenosis diagnosis confirms a benign, non-cancerous condition. In most instances, adenosis itself does not require specific treatment unless it causes bothersome symptoms like pain. Management typically involves monitoring rather than active intervention.
While most types of adenosis do not increase breast cancer risk, sclerosing adenosis might be associated with a slightly elevated risk. However, this risk is generally considered minimal, especially in cases without atypical features. Follow-up recommendations, such as regular screenings or clinical breast examinations, are typically tailored based on the specific type of adenosis and individual risk factors.