Cellular fibroadenoma on Core needle biopsy: management recommendations for the radiologist

Edwards, Teresa; Jaffer, Shabnam; Szabo, Janet; Sonnenblick, Emily B.; Margolies, Laurie

doi:10.1016/j.clinimag.2016.02.009

Cited by 14 publications

(15 citation statements)

References 17 publications

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“…Phyllodes tumors (PTs) are rare fibro-epithelial lesions with an incidence rate of approximately 1% of all primary breast lesions [ 1 ] and occur in women aged 35–55 years [ [2] ]. Fibro-epithelial lesions also include fibroadenomas (FAs), which are composed of balanced proliferation of glands and stroma [ 3 ]. However, PTs disturb the balance, with overgrowth of stroma, resulting in a leaf-shaped appearance.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors

Shang

Zhang

et al. 2020

The Breast

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Purpose To evaluate the value of ultrasound (US)-guided vacuum-assisted excisional biopsy (VAB) in treating benign phyllodes tumors (PTs) of the breasts and to investigate the lesion characteristics that could affect the local recurrence rate. Patient and methods From December 2008 to February 2018, 93 patients with PTs diagnosed on histology underwent US-guided, 7-gauge VAB. The recurrence rate of benign PT and complications of VAB were evaluated on follow-up US every three to six months. The lesion characteristics were analyzed to identify the factors affecting the recurrence rate. Results Of the 87 patients, local recurrence was found in 15 patients (17%) in a mean follow-up period of 35.8 months, and the rate of complete excision was 82.8% (72/87). PTs with a largest diameter less than 3.3 cm had a significantly lower recurrence rate than PTs with a largest diameter larger than 3.3 cm (P < 0.05). Conclusions In conclusion, US-guided VAB is an effective method to treat benign PT, especially in lesions with a diameter less than 3.3 cm.

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Section: Introductionmentioning

confidence: 99%

Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors

Shang

Zhang

et al. 2020

The Breast

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“…In CNB, the lesion most frequently misdiagnosed as PT is cellular fibroadenoma due to its increased stromal cellularity. Cellular fibroadenoma is usually seen in young women and surgical excision is recommended because of the larger size (10). In the current study, all the patients diagnosed with cellular fibroadenoma were younger than 35 years old.…”

Section: Discussionmentioning

confidence: 60%

Can Radiologist and Pathologist Reach The Truth Together in The Diagnosis of Benign Fibroepithelial Lesions?

Durhan

Önder

Azizova

et al. 2019

European Journal of Breast Health

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Objective: Benign fibroepithelial lesions (BFL) lesions of the breast are various and predominantly benign, although a few can be locally aggressive. Definitive diagnosis of some BFL can be challenging from core needle biopsy (CNB). Radiological findings can help guide the management of the lesions. The aim of this study was to investigate the accuracy rate of CNB results and evaluate the radiological findings of the most common BFL according to the final excision pathology results. The secondary aim was to assess the contribution of the imaging findings to CNB results. Materials and Methods:A retrospective review was made of 266 patients diagnosed with suspicious BFL, conventional fibroadenoma, complex fibroadenoma, cellular fibroadenoma and benign phyllodes tumor (PT). The study included 132 patients who underwent surgical excision. The radiological and histopathological findings were evaluated.Results: While 66 patients were diagnosed with more descriptive results on CNB, the other 66 patients were diagnosed with suspicious BFL. Agreement between CNB and excisional pathology was good, when CNB provided a definite diagnosis. While conventional and complex fibroadenoma were observed to have hypo or normal vascularity, cellular fibroadenoma and PT showed hypervascularity. Oval shaped and homogeneous internal echo pattern were significantly associated with conventional fibroadenoma. A heterogeneous internal echo pattern was seen in complex fibroadenomas and PT. Conclusion:CNB often reaches the correct diagnosis alone when it gives a definite diagnosis. The radiological findings which help in the differentiation of BFL are hypervascularity, oval shape and internal heterogeneity. More accurate results can be obtained when histopathological and radiological findings are evaluated together.

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“…Ultrasound scanning was used instead of mammography because of the density of breast tissue and the lack of mammographic sensitivity in young patients [6, 7]. Morphologically, sections revealed a cellular proliferation of multiplicated dense fibrous tissue and distended acinar structures lined by one or two layers of cuboid epithelial cells and surrounded by a fibrous capsule [8].…”

Section: Discussionmentioning

confidence: 99%

Recurrent giant fibroadenomas with transformation to cystosarcoma phyllodes in a 17-year-old girl: a rare case report from Syria

et al. 2019

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BackgroundFibroadenoma is the most prevalent benign breast lesion that generally affects middle-aged women; it is rare in adolescents and younger children. The transformation into malignancy is not common. However, multiple recurrences of rapidly enlarging fibroadenomas suggest a high possibility of transforming into phyllodes tumors, which are uncommon fibroepithelial lesions that account for 0.3–0.5% of female breast tumors and typically present in premenopausal women.Case presentationWe report a case of a 17-year-old Syrian girl who previously had three episodes of recurrence of multiple rapidly enlarging fibroadenomas in her left breast and underwent three operations for complete resection of the lesions. However, a few months later, she was readmitted with multiple large masses in the same breast, and pathological findings confirmed a surprising combination of multiple fibroadenomas for the fourth time with a malignant phyllodes tumor (cystosarcoma phyllodes). The patient underwent lumpectomies followed by adjuvant radiotherapy. Long-term follow-up was recommended.ConclusionOur patient had an extraordinary number of episodes of recurrence at a young age and a rare combination of malignant and benign lesions in the same breast with multiple recurrences. We present her unique, very challenging case with the aim of highlighting the importance of clinical correlation, detailed diagnosis, and careful follow-up.

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Cellular fibroadenoma on Core needle biopsy: management recommendations for the radiologist

Cited by 14 publications

References 17 publications

Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors

Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors

Can Radiologist and Pathologist Reach The Truth Together in The Diagnosis of Benign Fibroepithelial Lesions?

Recurrent giant fibroadenomas with transformation to cystosarcoma phyllodes in a 17-year-old girl: a rare case report from Syria

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