Accuracy and clinical implications of pre-operative breast core needle biopsy diagnoses of fibroepithelial neoplasms and sarcomatoid carcinomas.
Breast Cancer Res Treat
; 178(1): 51-56, 2019 Nov.
Article
en En
| MEDLINE
| ID: mdl-31332664
ABSTRACT
PURPOSE:
Accurate classification of breast phyllodes tumors (PTs) on core biopsy can be challenging. The differential diagnosis of benign PT (BP) is fibroadenoma (FA), whereas the differential diagnosis of malignant PT (MP) is sarcomatoid (metaplastic) carcinoma (SC).METHODS:
Here, we compare the pre-excision core biopsy diagnosis and clinicopathologic features of histologically confirmed MP, borderline PT (BLP), BP, FA, and SC. Consecutive cases of 34 histologically confirmed PT (14 MP, 10 BLP, 10 BP), 13 SC, and 10 FA were identified.RESULTS:
A core biopsy diagnosis of SC was made only in SC (77%, p = 0.003). The diagnosis "malignant neoplasm" or "atypical spindle cell neoplasm" was made in 100% MP and 23% SC, but no other tumor (p = 0.0001). The diagnosis "phyllodes tumor" was made only in PT (44% BLP, 11% BP, p = 0.06). The diagnosis "fibroepithelial lesion" was made in 44% BLP, 67% BP, and 29% FA. The diagnosis "FA" was made most commonly in FA (57%) (versus 22% BP and no other tumor; p = 0.002). Neoadjuvant therapy was given only in SC (23%, p = 0.03); adjuvant therapy was given in 46% SC and 13% MP (p = 0.04).CONCLUSIONS:
A pre-operative core biopsy diagnosis of "malignant spindle cell neoplasm" separates MP and SC from BLP, BP, and FA. However, MP and SC can have overlapping features on core biopsy. Thus, one must be careful not to overcall SC on core biopsy, as patients diagnosed with SC may receive neoadjuvant therapy. A core biopsy diagnosis of "phyllodes tumor" is specific for PT and can guide treatment planning of a wide local excision.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
/
Carcinoma
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Neoplasias Fibroepiteliales
/
Tumor Filoide
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Adult
/
Aged
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Aged80
/
Female
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Humans
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Middle aged
Idioma:
En
Revista:
Breast Cancer Res Treat
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos