Fibroepithelial lesions; The WHO spectrum

Krings, Gregor; Bean, Gregory R.; Chen, Yunn-Yi

doi:10.1053/j.semdp.2017.05.006

Cited by 77 publications

(72 citation statements)

References 123 publications

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“…Recurrence rates may have some variation in the literature, but overall are 10-17, 14-25 and 23-30% for benign, borderline and malign tumors, respectively. Metastatic potential is very low on borderline tumors (0-4%), whereas malignant tumors demonstrating metastatic potential up to 22% of cases 3,4 . There are extremely rare reports of metastasis on benign tumor with the qualification that all tumors should be adequately sampled account for intratumoral heterogeneity 3 .…”

Section: Discussionmentioning

confidence: 99%

“…PT is hypercellular fibroepithelial lesion that have a wide morphological spectrum. The benign PT shows overlapping features with cellular FA, whereas the malignant tumors may have a morphological resemblance with primary breast sarcoma or spindle cell metaplastic carcinoma 4 .…”

Section: Discussionmentioning

confidence: 99%

“…PT are rare, comprising only 0.3-1% of all primary breast tumors 4 . This lesion was first described by Joahnnes Müller in 1838 as Cystosarcoma Phyllodes, and its malignance behavior was recognized by Lee and Pack in 1931 in their series of 111 cases with one mortality by pulmonary metastasis 5 .…”

Section: Discussionmentioning

confidence: 99%

“…The age of presentation is usually 40-50 years, but these tumors can present at any age. Rare reports in men are often associated with gynecomastia, suggesting a role for hormonal influence on its physiopathology 4 .…”

Section: Discussionmentioning

confidence: 99%

“…PT is graded according to recommendations by the World Health Organization (WHO) as benign, borderline, or malignant based on the presence and degree of stromal cellularity, atypia, mitotic activity, border infiltration versus circumscription and stromal overgrowth 4 .…”

Section: Discussionmentioning

confidence: 99%

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Transformation of fibroadenoma to phyllodes tumor and the use of oncoplastic technique for breast conservative treatment

Prado¹,

Vieira²,

Neto³

et al. 2019

Mastology

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O tumor filoide (TF) é uma rara neoplasia que corresponde a menos de 1% das lesões mamárias. A tranformação do fibroadenoma (FA) em TF é um evento raro e imprevisível. Existem muitos desafios no manejo dos TF, desde o seu diagnóstico ao tratamento. Nós descrevemos o caso de uma paciente de 63 anos com TF com diagnóstico prévio de FA que foi submetida ao tratamento cirúrgico conservador da mama por técnicas oncoplásticas. Uma revisão da literatura sobre o diagnóstico e tratamento do TF foi realizada. O diagnóstico dessa condição pode ser especialmente difícil quando feito a partir de amostra de biópsias por agulha, e em caso de resultados negativos recomenda-se acompanhamento rigoroso. As técnicas oncoplásticas podem ser uma importante ferramenta no tratamento cirúrgico conservador desses pacientes. ABSTRACTPhyllodes tumors (PT) are rare neoplasms accounting for <1% of breast lesions. A transformation of a fibroadenoma (FA) to a PT is even more rare and unpredictable. Many challenges face PT management, since diagnostic through surgical treatment. We describe a case of a 63-year old woman with PT that was previously diagnosed as a FA who underwent an oncoplastic conservative surgery. A review of the literature on the diagnostic and surgical management of PT was performed. The diagnostic of PT can be hard mostly in needle biopsy, and the close follow up of negative lesions is recommended. Oncoplastic techniques might be an important tool on the conservative treatment of these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Transformation of fibroadenoma to phyllodes tumor and the use of oncoplastic technique for breast conservative treatment

Prado¹,

Vieira²,

Neto³

et al. 2019

Mastology

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MED12 somatic mutations encompassing exon 2 associated with benign breast fibroadenomas and not breast carcinoma in Indian women

Darooei

Khan

Rehan

et al. 2018

J of Cellular Biochemistry

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Fibroadenoma is the most common type of benign breast tumor, accounting for 90% of benign lesions in India. Somatic mutations in the mediator complex subunit 12 (MED12) gene play a critical role in fibroepithelial tumorigenesis. The current study evaluated the hotspot region encompassing exon 2 of the MED12 gene, in benign and malignant breast tumor tissue from women who presented for breast lump evaluation. A total of 100 (80 fibroadenoma and 20 breast cancer) samples were analyzed by polymerase chain reaction-Sanger sequencing. Sequence variant analysis showed that 68.75% of nucleotide changes were found in exon 2 and the remaining in the adjacent intron 1. Codon 44 was implicated as a hotspot mutation in benign tumors, and 86.36% of the identified mutations involved this codon. An in silico functional analysis of missense mutations using consensus scoring sorting intolerant from tolerant (SIFT), SIFT seq, Polyphen2, Mutation Assessor, SIFT transFIC, Polyphen2 transFIC, Mutation Assesor transFIC, I-Mutant, DUET, PON-PS, SNAP2, and protein variation effect analyzer] revealed that apart from variants involving codon 44 (G44S; G44H), others like V41A and E55D were also predicted to be deleterious. Most of the missense mutations appeared in the loop region of the MED12 protein, which is expected to affect its functional interaction with cyclin C-CDK8/CDK19, causing loss of mediator-associated cyclin depended kinase (CDK) activity. These results suggest a key role of MED12 somatic variations in the pathogenesis of fibroadenoma. For the first time, it was demonstrated that MED12 sequence variations are present in benign breast tumors in the south Indian population.

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Cellular fibroepithelial lesions diagnosed on core needle biopsy: Is there any role of clinical‐sonography features helping to differentiate fibroadenomas and phyllodes tumor?

Al-Arnawoot

Scaranelo

Fleming

et al. 2020

Journal of Surgical Oncology

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Objective The purpose of this study is to determine the role of clinico‐sonographic features of breast cellular fibroepithelial lesions (CFELs) diagnosed on core needle biopsy (CNB) in the differentiation between fibroadenoma (FA) and phyllodes. Materials and Methods Results of consecutive women with a CNB showing CFEL from 2005 to 2010 were retrospectively reviewed. Clinical and sonographic findings were compared with surgical outcomes. Chi‐square and Fisher's exact tests were used followed by a regression model for statistical analysis. Results A total of 131 women with 134 CFEL were included in the study; 89 (66%) were FAs and 45 (34%) were phyllodes (32 benign; 13 malignant). Significant predictors of increased risk of phyllodes tumor were patient age equal to or greater than 50 years (P = .021) and lesion size less than 2 cm at sonography (P = .043). No other imaging or clinical features were able to differentiate FA from phyllodes tumors. Conclusion CFEL with a larger size in older women is associated with the surgical pathological result of phyllodes tumor and management should be tailored accordingly. Younger patients with small size nodules might be approached less aggressively, depending on a personalized discussion with the surgeons, taking into account the results obtained in this study.

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Fibroepithelial lesions; The WHO spectrum

Cited by 77 publications

References 123 publications

Transformation of fibroadenoma to phyllodes tumor and the use of oncoplastic technique for breast conservative treatment

Transformation of fibroadenoma to phyllodes tumor and the use of oncoplastic technique for breast conservative treatment

MED12 somatic mutations encompassing exon 2 associated with benign breast fibroadenomas and not breast carcinoma in Indian women

Cellular fibroepithelial lesions diagnosed on core needle biopsy: Is there any role of clinical‐sonography features helping to differentiate fibroadenomas and phyllodes tumor?

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