It is an exciting time to learn and practice breast pathology. New molecular findings, novel immunostains, emerging biomarkers, digital image analysis, and artificial intelligence algorithms are refining our diagnoses and improving our patient care. These
advances do not replace but rather complement our glass slides and microscopes. Histology remains the wonderfully complex foundation of our diagnostic practice.
With this atlas, we create a comprehensive guide to diagnostic breast pathology that would be accessible and educational to trainees, as well as informative and useful to practicing pathologists. We envisioned a definitive desktop reference of images that we would reach for during study or sign-out of cases. We designed each image to provide a stand-alone teaching point, but also arranged them to tell a comprehensive story when read consecutively from start to finish.
This atlas presents the common and uncommon entities of breast pathology in the same way that we approach our clinical cases, that is, from low to high magnification.
Each entity is introduced with pertinent macroscopic features followed by histologic images, ancillary studies, and cytopathology. Multiple images of each entity illustrate the range of variant patterns, with an emphasis on potential diagnostic pitfalls. Concise figure legends accompany the images and describe the histologic findings, clinicoradiographic correlates,
differential diagnosis, and clinical significance.
The practice of breast pathology challenges us to ask more questions and think more deeply. We provide answers to the many diagnostic questions we ask ourselves every day, from the fundamental (what is the histologic pattern?) to the problematic (is that solid nodule actually a papillary lesion?). These questions are an essential component of the joy of discovery and diagnosis, and of our responsibility to our patients.
We believe this atlas will be a helpful resource in your own practice of breast pathology.