Fibroadenoma: Can fine needle aspiration biopsy avoid short term follow-up?

Leconte, Isabelle; Abraham, C.; Galant, Christine; Sy, Marième; Berlière, Martine; Fellah, Latifa

doi:10.1016/j.diii.2012.04.023

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…PTs tend to be larger and grow more rapidly than FAs , although giant FAs that measure 5 cm or more do exist even in paediatric patients . Approximately 10–20% of all breast lumps are diagnosed as FAs , while the incidence of PTs is between 0.3% and 1% . PTs are reported to be more common among Asian and Hispanic women than in non‐Asians .…”

Section: Introductionmentioning

confidence: 99%

Genomic characterisation of breast fibroepithelial lesions in an international cohort

Nasir

Rajasegaran

et al. 2019

The Journal of Pathology

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Fibroepithelial lesions (FELs) are a heterogeneous group of tumours comprising fibroadenomas (FAs) and phyllodes tumours (PTs). Here we used a 16-gene panel that was previously discovered to be implicated in pathogenesis and progression, to characterise a large international cohort of FELs via targeted sequencing. The study comprised 303 (38%) FAs and 493 (62%) PTs which were contributed by the International Fibroepithelial Consortium. There were 659 (83%) Asian and 109 (14%) non-Asian FELs, while the ethnicity of the rest was unknown. Genetic aberrations were significantly associated with increasing grade of PTs, and were detected more in PTs than FAs for MED12, TERT promoter, RARA, FLNA, SETD2, TP53, RB1, EGFR, and IGF1R. Most borderline and malignant PTs possessed ≥ 2 mutations, while there were more cases of FAs with ≤ 1 mutation compared to PTs. FELs with MED12 mutations had significantly higher rates of TERT promoter, RARA, SETD2, EGFR, ERBB4, MAP3K1, and IGF1R aberrations. However, FELs with wild-type MED12 were more likely to express TP53 and PIK3CA mutations. There were no significant differences observed between the mutational profiles of recurrent FAs, FAs with a history of subsequent ipsilateral recurrence or contralateral occurrence, and FAs without a history of subsequent events. We identified recurrent mutations which were more frequent in PTs than FAs, with borderline and malignant PTs harbouring cancer driver gene and multiple mutations. This study affirms the role of a set of genes in FELs, including its potential utility in classification based on mutational profiles.Conflict of interest statement: PHT, BTT, and PT jointly hold patent applications for PCT/SG2015/050107 (Breast fibroadenoma susceptibility mutations and use thereof) and PCT/SG2015/050368 (Method and kit for pathologic grading of breast neoplasms). The other authors declare no competing interests.

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Section: Introductionmentioning

confidence: 99%

Genomic characterisation of breast fibroepithelial lesions in an international cohort

Nasir

Rajasegaran

et al. 2019

The Journal of Pathology

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“…Fibroadenoma is a frequent benign tumor of the breast, which can be detected in 20% of all breast masses of premenopausal women and in 10% of postmenopausal breast tumors [13]. Usually fibroadenomas arise in the terminal ductal-lobular unit of the breast gland and can be divided in pericanalicular fibroadenomas, which consist of intact gland spaces arranged in single or multiple cell layers and concentric arrangement of the adjacent stroma and in intracanalicular fibroadenomas, in which the stroma undergoes active proliferation, causing compression of the gland tissue and thus leading to a reduction of the lumen.…”

Section: Introductionmentioning

confidence: 99%

High resolution compression elastography and color doppler sonography in characterization of breast fibroadenoma

Rjosk-Dendorfer

Reu

Deák

et al. 2014

Clinical Hemorheology and Microcirculation

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PURPOSE: To evaluate the use of color Doppler sonography and free hand sonoelastography in the assessment of breast fibroadenomas according to their size and shape. MATERIALS AND METHODS: From December 2012 to March 2013 women with 16 solid breast masses, classified as BI-RADS category 3 or 4 were examined with B-mode ultrasound, sonoelastography and color Doppler sonography. Lesions were subdivided according to their shape in round, ovoid or macrolobulated and according to their size (<2.0 cm or ≥2.0 cm). Two readers assessed sonoelastographic findings at 12.5 MHz using the tsukuba elasticity score and results of Doppler sonography using a score of 0, 1 or 2, depending on the degree of perfusion. RESULTS: Among the 16 examined lesions 3 showed a round shape, 9 were ovoid and in 4 cases a macrolobulated appearance could be seen. No significant differences concerning Tsukuba-score depending on various shapes of fibroadenomas in Bmode sonography could be shown (p = 0.91) and also comparison of Tsukuba-scores and size of masses revealed no significant differences (p = 1.0). Sizes of fibroadenomas ≥2 cm were significantly associated with an increased vascularization of the lesions (p = 0.04) and a macrolobulated appearance in B-mode sonography (p = 0.04). CONCLUSION: The combination of color Doppler sonography and sonoelastography in addition to B-mode sonography leads to an increased accuracy in distinguishing benign from malignant breast masses and to an improvement in characterization of fibroadenomas independent of their shape or size.

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“…Leconte et al [10] presented a series of 427 masses with the diagnosis of fibroadenoma after FNAC. No cancer was detected in this group, by biopsy or by follow up.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Fine-Needle Aspiration Cytology: Diagnostic Value in Breast Solid Masses

Febles¹,

Acqua²,

Cristiani³

et al. 2016

medical-oncology

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Objective: To evaluate the efficacy of ultrasound-guided fine-needle aspiration cytology for the diagnosis of breast solid masses.Materials and method: It is a retrospective study with 705 patients carrying a solid breast mass who underwent ultrasound-guided fine-needle aspiration cytology for the diagnosis. The fine needle aspiration cytology (FNAC) was performed with ultrasound guidance and a 21 G gauge needle was used. The cytological results were classified as benign, suspicious, malignant or insufficient. The benign results were considered negative for malignancy and the malignant and suspect results were considered positive for malignancy. Insufficient results were not included in analysis of the accuracy of the study.In all cases the histological result of the masses was obtained and it was taken as reference test. The ultrasound-guided FNAC accuracy was evaluated for all cases and then specifically for the masses classified in the categories 3, 4 and 5 of BI-RADS.Results: When all cases were included the results were the following: sensitivity 96%, specificity 92%, positive predictive value 97%, negative predictive value 89%, false positives 3%, false negatives 11% and overall accuracy 95%. For the BI-RADS category 3 the results were the following: sensitivity 100%, specificity 98%, positive predictive value 90%, negative predictive value 100%, false positives 10%, there were no false negatives and overall accuracy 98%.For the BI-RADS category 4 the results were the following: sensitivity 92%, specificity 85%, positive predictive value 95%, negative predictive value 78%, false positives 5 %, false negatives 21% and overall accuracy 91%. For the BI-RADS category 5 the results were the following: sensitivity 99%, specificity 75%, positive predictive value 99.6%, negative predictive value 40%, false positives 0.4%, false negatives 60% and overall accuracy 99%. Conclusion:Ultrasound-guided FNAC is a valuable diagnostic technique for breast solid masses. In the probably benign masses (BI-RADS 3) its objective is to rule out malignancy for safely avoid biopsy and planning an imaging follow-up. In the suspicious and highly suggestive of malignancy masses (BI-RADS 4 and 5) the objective is to confirm malignancy prior to definitive treatment, when neoadjuvant chemotherapy is not needed.

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Fibroadenoma: Can fine needle aspiration biopsy avoid short term follow-up?

Abstract: The use of fine needle aspiration biopsy, interpreted by an experienced cytologist, means that short term follow-up of fibroadenomas can be avoided.

Cited by 7 publications

References 22 publications

Genomic characterisation of breast fibroepithelial lesions in an international cohort

Genomic characterisation of breast fibroepithelial lesions in an international cohort

High resolution compression elastography and color doppler sonography in characterization of breast fibroadenoma

Ultrasound-Guided Fine-Needle Aspiration Cytology: Diagnostic Value in Breast Solid Masses

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