Surgical Pathology Criteria

Pubertal Macromastia

Differential Diagnosis

Pubertal Macromastia Juvenile Fibroadenoma
Diffuse, not circumscribed Circumscribed
Fibrous or fatty stroma Cellular stroma
Rare More common as a cause of adolescent breast enlargement
Both may cause rapid, massive growth

Pubertal Macromastia Phyllodes Tumor
Young age (10-17 years) Almost all over 30 years
No discrete mass Mass usually present
No broad papillae Broad papillae inserted into spaces
Paucicellular stroma Cellular stroma
No stromal mitotic figures May have stromal mitotic activity
No stromal atypia Stromal atypia may be present
Both may cause rapid, massive growth

Pubertal Macromastia Juvenile Papillomatosis
Diffuse Circumscribed
Massive enlargement Mean size 4 cm
Usually bilateral Usually solitary
Predominantly stromal process Prominent cysts

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