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

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.

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Accuracy of fine needle aspiration compared to core needle biopsy in breast masses

Journal of Shahrekord University of Medical Sciences ◽

10.34172/jsums.2019.13 ◽

2019 ◽

Vol 21 (2) ◽

pp. 75-79

Author(s):

Mohammad Moazeni Bistgani ◽

Monem Basravi ◽

Abdolmajid Taheri ◽

Shahla Taheri ◽

Soleyman Kheiri

Keyword(s):

Fine Needle Aspiration ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

High Sensitivity ◽

Needle Aspiration ◽

Predictive Values ◽

Breast Masses ◽

Core Needle ◽

Fine Needle ◽

Sensitivity Specificity

Background and aims: Breast cancer is one of the main causes of death in women, the early diagnosis of which is made by physical examination, mammography, ultrasound, and biopsy of breast masses. The aim of this study was to assess the diagnostic accuracy of fine needle aspiration (FNA) compared to core needle biopsy (CNB) in breast masses. Methods: The current descriptive study was conducted in Kashani and Hajar hospitals in 2015. And a total of 200 patients diagnosed with breast masses participated in this study. First, patients referred to the clinic, received local anesthesia in the area, and then underwent FNA using 10 cc syringes and 23G needles, and simultaneously CNB specimens were taken by a special needle for diagnosis. FNA and CNB specimens were transferred to the Pathology Department with a few day interval for cytological interpretation. Results: The sensitivity and specificity of FNA compared to CNB in the diagnosis of malignant breast masses were 83.9% and 89.9%, respectively. Moreover, the positive and negative predictive values of FNA for breast masses were 78.8% and 92.5%, respectively. The accuracy of FNA test for breast masses was also 0.88%. Conclusion: According to the results of this study, FNA test had a high sensitivity, specificity, and predictive value in the diagnosis of breast masses. Therefore, it could be used as an appropriate diagnostic tool, and could obviously save many costs as well.

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An analysis of fine needle aspiration versus core needle biopsy in clinically palpable breast lesions: a report on the predictive values and a cost comparison

The American Journal of Surgery ◽

10.1016/j.amjsurg.2011.10.018 ◽

2012 ◽

Vol 204 (2) ◽

pp. 193-198 ◽

Cited By ~ 15

Author(s):

Sapna Nagar ◽

Anthony Iacco ◽

Thomas Riggs ◽

William Kestenberg ◽

Richard Keidan

Keyword(s):

Fine Needle Aspiration ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Needle Aspiration ◽

Cost Comparison ◽

Breast Lesions ◽

Predictive Values ◽

Core Needle ◽

Fine Needle ◽

Palpable Breast

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

The American Journal of Surgery ◽

10.1016/j.amjsurg.2016.12.017 ◽

2017 ◽

Vol 214 (2) ◽

pp. 318-322 ◽

Cited By ~ 8

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

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Differentiation Between Phyllodes Tumor and Fibroadenoma Using Real-Time Elastography

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0031-1282024 ◽

2011 ◽

Vol 32 (S 02) ◽

pp. E75-E79 ◽

Cited By ~ 3

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.

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