A 42-year-old woman undergoes her first mammogram. Clustered microcalcifications are seen but there is no mass palpable. Which of the following statement(s) is/are true concerning this patient’s diagnosis and management?

a. A needle localization and excision of the mass is necessary to establish the diagnosis

c. Intense interlobular fibrosis and proliferation of small ductules with loss of orientation of lobules and epithelial cells may suggest carcinoma

Sclerosing adenosis is a histologic subtype of fibrocystic change that is not associated with an increased risk of cancer development. It is, however, one of the benign breast processes most likely to be confused radiologically and histologically with cancer. Most commonly, it is detected on routine mammography as cluster microcalcifications without an associated palpable mass. In these cases, needle localization and excision are required to establish a diagnosis. Sclerosing adenosis microscopically is characterized by interlobular fibrosis and proliferation of small ductules. If the fibrous component is particularly intense, the orientation of lobules and epithelial cells may be lost, mimicking carcinoma. Differentiating sclerosing adenosis from cancer on frozen-section examination can be particularly difficult and should not be attempted.