Ultrasonography and core needle biopsy in the differential diagnosis of fibroadenoma and tumor phyllodes

Bode, Michaela K.; Rissanen, Tiina H.; Apaja‐Sarkkinen, M.

doi:10.1080/02841850701367911

Cited by 48 publications

(71 citation statements)

References 23 publications

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“…highest among all relevant studies. Choi (12) reported that among 129 patients having undergone preoperative CNB diagnosis, 104 were verified by postoperative pathology, yielding an accuracy rate of 80.6%, similar to the results of Bode et al (11). In addition, Komenaka et al (22) and Ward et al (17) reported accurate CNB diagnostic rates of 76.0% and 63.0%.…”

Section: Discussionsupporting

confidence: 73%

“…Bolívar et al (26) proposed obtaining a minimum of three specimens via ultrasound-guided CNB for cases of breast tumors that were difficult to examine via palpation. Bode et al (11) reported that using 14 G or 16 G biopsy needles could deliver a relatively improved outcome in differentiating a PTB specimen from that of FA. Although 14 G needles were used in this study, only 1 specimen was obtained from each breast tumor patients, which might explain the relatively low rate of accurate CNB diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, the breast diagnostic methods currently available do not distinctly reveal PTB and have a high misdiagnosis rate, which compromises the development of appropriate therapeutic plans and accurate assessments of prognosis (11)(12)(13)(14)(15)(16). Among various preoperative auxiliary examinations, mammogram, ultrasound, and fine needle aspiration (FNA) all have a poor diagnostic performance for PTB (12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance of core needle biopsy in identifying breast phyllodes tumors

Zhou¹,

Wang²,

Sun³

et al. 2016

J. Thorac. Dis.

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Background: A retrospective analysis of diagnoses was performed in patients with phyllodes tumors of the breast (PTB) who received preoperative core needle biopsy (CNB) and had breast surgery at Fudan University Shanghai Cancer Center from January 1, 2002 to April 1, 2013. The resulting data allowed us to compare the accordance between CNB and excision diagnoses of PTB patients and evaluate the accuracy of CNB in preoperative diagnosis. Methods:Data from 128 patients with PTB who had undergone preoperative CNB and breast surgery were retrospectively analyzed. We reviewed the medical history, clinical follow-up data, and CNB diagnostic data. A diagnostic test was used to evaluate the sensitivity and specificity of CNB in diagnosing benign, borderline, and malignant phyllodes tumors.Results: The accuracy of CNB for diagnosing PTB was 13.3% (17/128). Of the remaining patients, 98(75.5% of the PTB patients) were diagnosed with fibroadenoma or fibroepithelial lesions. The sensitivity of CNB at diagnosing benign, borderline, and malignant phyllodes tumors were 4.9% (2/41), 4.2% (3/71), and 25.0% (4/16), respectively, whereas the corresponding specificity were 92.0%, 98.2%, and 100%, respectively. Some clinical features, such as large tumor size, rapid growth, or surgical history of fibroadenomas, were indicative of an increased possibility of PTB.Conclusions: CNB provides a pathological basis for the preoperative diagnosis of PTB, but it has a poor accuracy and offers limited guidance for surgical decisions. Considering CNB along with multiple histologic features may improve the ability to accurately diagnose PTB. An integrated assessment using CNBs in combination with clinical data and imaging features is suggested as a reliable strategy to assist PTB diagnosis.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance of core needle biopsy in identifying breast phyllodes tumors

Zhou¹,

Wang²,

Sun³

et al. 2016

J. Thorac. Dis.

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“…Patients older than 50 to 55 years are more likely to have a phyllodes tumor (7). In the present study, age was not a useful discriminant, unlike other studies (2,4,9). This finding may be explained by the fact that a surgical excision was usually performed in older patients at our institution if an initial CNB revealed a fibroepithelial lesion, regardless of other features suggestive of a fibroadenoma.…”

Section: Discussioncontrasting

confidence: 56%

“…older than patients with fibroadenomas (1,4,9). Patients older than 50 to 55 years are more likely to have a phyllodes tumor (7).…”

Section: Discussionmentioning

confidence: 99%

Fibroadenoma versus phyllodes tumor: distinguishing factors in patients diagnosed with fibroepithelial lesions after a core needle biopsy

Wiratkapun¹,

Piyapan²,

Lertsithichai³

et al. 2014

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to identify factors that might help differentiate phyllodes tumors from fibroadenomas among cases in which a fibroepithelial breast lesion was diagnosed from core needle biopsy (CNB) under imaging guidance. MATERIALS AND METHODSA retrospective review was performed on 213 lesions in 200 patients who had undergone both CNB and excisional biopsy during a four-year period between 2008 and 2011. The final pathology revealed 173 fibroadenomas and 40 phyllodes tumors. The data, including patient characteristics, clinical presentation, and mammography, ultrasonography (US), and pathology findings were analyzed. RESULTSUpon univariable analysis, the factors that significantly helped to identify phyllodes tumors consisted of the presenting symptoms (palpable mass or breast pain), increased size on clinical examination, hyperdense mass on mammogram, and the following three US features: heterogeneous echo, presence of round cysts within the mass, and presence of clefts within the mass. The pathologist's suggestion of a phyllodes tumor was also helpful. The factors that remained statistically significant upon multivariable analysis consisted of symptoms of breast pain, the presence of clefts on US, the presence of round cysts on US and the pathologist's favoring of phyllodes tumors from a CNB specimen. CONCLUSION A multidisciplinary approach was needed to distinguish phyllodes tumors from fibroadenomas in patients who had undergone CNB. US findings (clefts and round cysts), suggestive pathological diagnoses, and clinical symptoms were all useful for the decision to surgically remove the fibroepithelial lesions diagnosed from CNB.

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Gray‐scale and color Doppler sonographic features of complex fibroadenomas of the breast

Lee

Kim

Park

et al. 2015

J of Clinical Ultrasound

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Ultrasonography and core needle biopsy in the differential diagnosis of fibroadenoma and tumor phyllodes

Cited by 48 publications

References 23 publications

Diagnostic performance of core needle biopsy in identifying breast phyllodes tumors

Diagnostic performance of core needle biopsy in identifying breast phyllodes tumors

Fibroadenoma versus phyllodes tumor: distinguishing factors in patients diagnosed with fibroepithelial lesions after a core needle biopsy

Gray‐scale and color Doppler sonographic features of complex fibroadenomas of the breast

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