Overdiagnosis of breast malignancy: Azzopardi's Problems in Breast Pathology revisited, Part I

Dr. John G. Azzopardi's textbook Problems in Breast Pathology is a critical work for breast pathologists. His observations on over- and underdiagnosis of breast malignancy are summarized in two chapters which are highly educational for everyday practice to reach an accurate diagnosis. Almost five decades later, his observations are still valid, and the same problems persist. In two separate reviews, we revisit these chapters and discuss these diagnostic challenges with an updated perspective and include developments (most importantly immunohistochemistry) in the field since then. In part I, lesions which may be overdiagnosed as malignancy are discussed, including those that were covered in Dr. Azzopardi's textbook (mainly sclerosing adenosis and radial scar) and some others that exert challenges on the pathologist. In part II, we will cover underdiagnosis of breast malignancy.