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Amyloid in the breast: Retrospective review with clinicopathological and radiological correlation of 32 cases from a single institution

Histopathology May 14, 2021

Duckworth LA, Cotta CV, Rowe JJ, et al. - Using the Department of Pathology database from 1993 to 2019, researchers herein analyzed the clinicopathological and radiographic features of mammary amyloid. They found 32 cases from 23 patients, including consultation cases. The study sample comprised females with age range = 52–81 (mean = 67.4 years). There were 14 patients who offered clinical history, among these, presentations of amyloid included a mass clinically or radiographically (six patients, 43%), as microcalcifications (five patients, 36%), and only occasionally as an asymmetry (14%) or fibroglandular density (7%). In an additional nine cases (total 14 patients; 44% of the cohort), microcalcifications were revealed on microscopic examination. Presence of concurrent epithelial and haematological malignancy and amyloid within an axillary lymph node was found in one patient. Autoimmune diseases and multiple myeloma were identified as co‐morbidities. Most of the mammary amyloid cases were found to be related to benign histopathological findings, while microcalcifications or mass lesions were most frequently revealed on imaging. Considering a low threshold for performing ancillary stains is advised for elderly females with benign core needle findings conducted for mass lesions or microcalcifications, to prevent overlooking amyloid as simply fat necrosis or fibroelastotic stromal change.

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