Lesions of the breast are preponderantly confined to the female. In the male and
female prior to puberty the breast is a rudimentary structure relatively insensitive to
endocrine influence, such as ovarian, pituitary and adrenal hormones and apparently and
adrenal hormones and apparently to neoplastic growth.
In the female after puberty, on the other hand, the more complex breast structure, the
greater breast volume and the extreme sensitivity to endocrine influences all predisposed
this organ to a number of pathologic conditions.
To an almost exclusive degree, then, the woman who today presents herself with a
dominant complaint related to the mammary glands will prove to be diagnosable as one
of the "big three" : (1) dysplasia, (2) benign neoplasia, most often fibroadenoma, or (3)
malignant neoplasia, most often carcinoma.
The many Patterns of breast Pathology included under the designation fibrocystic
diseases and other benign tumors have great clinical importance for two reasons, (1)
They produce masses in the breast that require differentiation from carcinoma, and (2)
They may predisposed to the subsequent development of carcinoma. Two diametrically
opposite viewpoints have long been held equally vehemently, that fibrocystic diseases
predispose to cancer, and there is no causal relationship between the two disorders.
Warren (1964) in several years follow-up of 1200 cases of cystic disease, cites a
cancer rate 4.5 times greater than in patients with normal breast.
Other reports indicate that between 10 and 12 per cent of breasts with preexisting
fibrocystic diseases of the breast develop cancer, two or threefold increased attack rate
(Kilgore et al., 1953; Pessagno,1957).
Looked at from the opposite point of view, 60 to 90 per cent of breasts with
carcinoma have accompany cystic diseases.
Notwithstanding these findings, the issue of the relationship of fibrocystic diseases to
carcinoma is still unsettled, and many sti11 contend that there is no increased attack
rate of carcinoma in breast having the pathologic changes of mammary dysplasia.
The incidence of breast carcinoma is different geographically and racially. Among
women in the United States and Europe, breast is the leading site of cancer in both
incidence and mortality. But in Korea, Japan, other Asian and African countries, the
incidence of breast cancer is low.
Breast carcinoma may appear at any age in either sex. However, it is rarely
encountered in persons under the age of 30 years of women and men. It occurs about
100 times as frequently in women as in man.
The pathogenesis of the breast carcinoma is unknown, but hormonal factor, genetic
factor, viral and traumatic factor are important role and precancerous lesions are
considered from chronic cystic mastitis and papilloma of the breast.
The overwhelming number of malignant tumors of breast parenchyma are carcinomas,
and almost carcinomas of the breast are ductal in origin. It is important to divide breast
carcinomas into different types. If these types can be identified, then some statement
can be made of the probable extent of the lymph node metastases and thereby
prognosis. So recently Tornberg's classification (1960) is widely used.
Tumor size, histologic types of breast cancer, location, nuclear grade, sinus
histiocytosis of lymph nodes and invasion of blood vessels are features that have been
claimed to be of prognostic significance of breast cancer.
The most important single prognostic factor is the presence or absence of involved
axillary lymph nodes.
There are several reports on breast disorders among Koreans based on clinical and
statistical aspects but there is no report on breast disorder, especially breast carcinomas
based on histopathological aspects.
The present study is an attempt to investigate mainly histopathological characteristics,
such as classification of breast carcinoma according to cellular growth pattern, nuclear
grade, sinus histiocytosis of lymph nodes, relationship between histologic types of breast
carcinoma, location, nuclear grade and size vs. axillary lymph node metastases, and
combined diseases of uninvolved breast parenchyma in breast carcinoma.
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