Differentiation Between Phyllodes Tumor and Fibroadenoma Using Real-Time Elastography

2011 ◽  
Vol 32 (S 02) ◽  
pp. E75-E79 ◽  
Author(s):  
B. Adamietz ◽  
L. Kahmann ◽  
P. Fasching ◽  
R. Schulz-Wendtland ◽  
M. Uder ◽  
...  
Keyword(s):  
Real Time ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Phyllodes Tumor ◽  
Breast Lesions ◽  
Rare Entity ◽  
Core Needle ◽  
Malignancy Rate ◽  
Phyllodes Tumors ◽  
Elastic Characteristics

Abstract Purpose: Phyllodes tumors (PT) are a rare entity accounting for less than 1 % of all breast lesions. They have a malignancy rate of 25 – 30 %. Differentiation from benign fibroadenomas is difficult using ultrasound, mammogram and MRI. The elastic characteristics of both tumors were examined using real-time elastography (RTE) to find specific patterns that make differentiation possible. Materials and Methods: From February 2007 to May 2009, a total of 620 women were examined by RTE. Histological diagnosis was achieved using core needle biopsy. 123 of the lesions were fibroadenomas, 8 were phyllodes tumors. All patients underwent mammography and ultrasound followed by RTE. Sonography was performed by Acuson Antares, Premium Edition® (Siemens, Erlangen, Germany) with a 7 and 10 MHz transducer. Results: All phyllodes tumors had a similar elastic pattern with an elastic center and inelastic outer limits, referred to as the “ring sign”. It was found in 5 % of all fibroadenomas. Conclusion: RTE provides a specific elastic pattern, which is sufficient for differentiating between a fibroadenoma and a phyllodes tumor. Therefore, the detection of the most suspicious lesion in women with the coexistence of multiple fibroadenomas and phyllodes tumors seems easier.

Phyllodes Tumors

2017 ◽  
Author(s):  
Tina J Hieken ◽  
Rafael E Jimenez
Keyword(s):  
High Risk ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Phyllodes Tumor ◽  
Oncologic Outcomes ◽  
Breast Adenocarcinoma ◽  
Adjuvant Radiation ◽  
Core Needle ◽  
Phyllodes Tumors ◽  
Stromal Component

Phyllodes tumors are rare primary breast neoplasms graded as benign, borderline, or malignant based on pathology characterization of the stromal component. Core-needle biopsy is recommended as the first diagnostic step for breast lesions suspicious for phyllodes. Surgical excisional biopsy is recommended for a core-needle biopsy showing cellular fibroepithelial lesion or a mass suspicious for phyllodes tumor as pathology diagnosis is challenging, especially on limited tissue specimens. Surgical treatment parallels that for soft tissue sarcoma rather than breast adenocarcinoma. Wide local excision and mastectomy, with 1 cm tumor-free margins, provide equivalent oncologic outcomes. Tumor enucleation, subtotal resection, and positive final margins should be avoided. Axillary surgery is not recommended as lymph node metastases are rare. Adjuvant radiation is not recommended as routine, nor is adjuvant chemotherapy, although either or both may be considered for primary or recurrent high-risk malignant phyllodes tumors on a case-by-case basis. Local recurrence rates are influenced by margin status and tumor grade. Distant metastases occur in up to 25% of patients with borderline/malignant tumors and bestow a poor prognosis. Recent molecular genetic analyses of phyllodes tumors have identified potentially targetable mutations that may guide future therapy for high-risk, recurrent, or metastatic phyllodes tumors. This review contains 5 figures, 5 tables, and 53 references. Key words: biomarkers, breast sarcoma, diagnosis, outcomes, pathology, phyllodes tumor, surgery, treatment

Phyllodes Tumors

2017 ◽  
Author(s):  
Tina J Hieken ◽  
Rafael E Jimenez
Keyword(s):  
High Risk ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Phyllodes Tumor ◽  
Oncologic Outcomes ◽  
Breast Adenocarcinoma ◽  
Adjuvant Radiation ◽  
Core Needle ◽  
Phyllodes Tumors ◽  
Stromal Component

Phyllodes tumors are rare primary breast neoplasms graded as benign, borderline, or malignant based on pathology characterization of the stromal component. Core-needle biopsy is recommended as the first diagnostic step for breast lesions suspicious for phyllodes. Surgical excisional biopsy is recommended for a core-needle biopsy showing cellular fibroepithelial lesion or a mass suspicious for phyllodes tumor as pathology diagnosis is challenging, especially on limited tissue specimens. Surgical treatment parallels that for soft tissue sarcoma rather than breast adenocarcinoma. Wide local excision and mastectomy, with 1 cm tumor-free margins, provide equivalent oncologic outcomes. Tumor enucleation, subtotal resection, and positive final margins should be avoided. Axillary surgery is not recommended as lymph node metastases are rare. Adjuvant radiation is not recommended as routine, nor is adjuvant chemotherapy, although either or both may be considered for primary or recurrent high-risk malignant phyllodes tumors on a case-by-case basis. Local recurrence rates are influenced by margin status and tumor grade. Distant metastases occur in up to 25% of patients with borderline/malignant tumors and bestow a poor prognosis. Recent molecular genetic analyses of phyllodes tumors have identified potentially targetable mutations that may guide future therapy for high-risk, recurrent, or metastatic phyllodes tumors. This review contains 5 figures, 5 tables, and 53 references. Key words: biomarkers, breast sarcoma, diagnosis, outcomes, pathology, phyllodes tumor, surgery, treatment

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

2007 ◽  
Vol 48 (7) ◽  
pp. 708-713 ◽  
Author(s):  
M. K. Bode ◽  
T. Rissanen ◽  
M. Apaja-Sarkkinen
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Breast Lesions ◽  
Predictive Values ◽  
Core Needle ◽  
Phyllodes Tumors ◽  
Combined Use ◽  
The Us ◽  
Sensitivity Specificity ◽  
Histological Results

Background: The diagnosis of phyllodes tumors of the breast is challenging due to many similarities with common fibroadenomas. Purpose: To determine the diagnostic accuracy of core needle biopsy in diagnosing phyllodes tumors and to analyze the ultrasonographic (US) features of phyllodes tumors and fibroadenomas. Material and Methods: From 1999 to 2003, 1010 breast lesions underwent imaging-guided core needle biopsy. Of these, 57 fibroadenomas and 12 phyllodes tumors were removed surgically. The US and needle biopsy results of a total of 64 lesions (52 fibroadenomas and 12 phyllodes tumors) were further analyzed, compared, and correlated with surgical histological results. Results: The median sonographic sizes of the phyllodes tumors and the fibroadenomas were 3.2 cm and 1.6 cm, respectively. At US, 58% of the phyllodes tumors (7/12) were classified as equivocal or suspicious of malignancy and 42% (5/12) as probably benign, while 54% of the fibroadenomas (28/52) were classified as probably benign and 46% (24/52) as equivocal. The sensitivity, specificity, and positive and negative predictive values of core needle biopsy histology regarding tumor phyllodes were 83%, 92%, 71%, and 96%, respectively. Conclusion: Imaging-guided core needle biopsy was accurate in differentiating between fibroadenomas and phyllodes tumors. US classification was unreliable due to considerable overlap in the findings. Combined use of US feature analysis and needle biopsy may help to avoid the misinterpretation of phyllodes as fibroadenoma.

Fibroepithelial breast lesions diagnosed by core needle biopsy demonstrate a moderate rate of upstaging to phyllodes tumors

2017 ◽  
Vol 214 (2) ◽  
pp. 318-322 ◽  
Author(s):  
Gabriel Marcil ◽  
Stephanie Wong ◽  
Nora Trabulsi ◽  
Alexandra Allard-Coutu ◽  
Armen Parsyan ◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Breast Lesions ◽  
Core Needle ◽  
Phyllodes Tumors ◽  
Moderate Rate

Development of a Management Algorithm for the Diagnosis of Cellular Fibroepithelial Lesions From Core Needle Biopsies

2018 ◽  
Vol 26 (8) ◽  
pp. 684-692 ◽  
Author(s):  
Jaehag Jung ◽  
Eunyoung Kang ◽  
Su Min Chae ◽  
Hyojin Kim ◽  
So Yeon Park ◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Scoring System ◽  
Needle Biopsy ◽  
Characteristic Curve ◽  
Phyllodes Tumor ◽  
Surgical Excision ◽  
Multivariate Logistic Regression Model ◽  
Core Needle ◽  
Factors Associated ◽  
Phyllodes Tumors

Purpose. Surgical excision is recommended for complete evaluation of cellular fibroepithelial lesions identified from core needle biopsy. The purpose of this study was to determine factors associated with phyllodes tumor among cellular fibroepithelial lesions from core biopsies and develop a scoring system to predict the risk of phyllodes tumor. Methods. We retrospectively reviewed clinical data of 169 breast lesions that were diagnosed as cellular fibroepithelial lesions from core needle biopsy at the Seoul National University Bundang Hospital between March 2005 and January 2013. The clinical, histopathologic, and radiologic characteristics were compared between phyllodes tumors and fibroadenomas during the final diagnosis after surgical excision. Results. Of the 169 lesions, 17 were observed and 152 were surgically removed. After excision, final pathology revealed 60 (39.5%) fibroadenomas and 92 (60.5%) phyllodes tumors. Multivariate analysis demonstrated that age (≥40 years), stromal overgrowth, and stromal cellularity were independent factors associated with phyllodes tumors. A scoring system was developed based on a multivariate logistic regression model, and the area under the receiver operating characteristic curve was 0.828 (95% confidence interval = 0.763-0.893). Conclusion. The scoring system will help clinicians make appropriate treatment for patients with cellular fibroepithelial lesions on core needle biopsy.

Large-core needle biopsy for diagnosis and treatment of breast lesions

2002 ◽  
Vol 266 (4) ◽  
pp. 198-200 ◽  
Author(s):  
B. Smyczek-Gargya ◽  
U. Krainick ◽  
M. Müller-Schimpfle ◽  
G. Mielke ◽  
R. Mayer ◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Diagnosis And Treatment ◽  
Breast Lesions ◽  
Large Core ◽  
Core Needle

scholarly journals Accuracy of 16/18G core needle biopsy for ultrasound-visible breast lesions

2014 ◽  
Vol 12 (1) ◽  
pp. 7 ◽  
Author(s):  
Jie-Ying Zhou ◽  
Jie Tang ◽  
Zhi-Li Wang ◽  
Fa-Qin Lv ◽  
Yu-Kun Luo ◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Breast Lesions ◽  
Core Needle
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