Correlation between fibroepithelial lesions with breast core needle biopsy and surgical excision

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Piyapharom Intarawichian
Kuntinun Kanchana
Waritta Kunprom
Ongart Somintara
Supinda Koonmee
Chaiwat Aphivatanasiri

Abstract

Fibroepithelial lesions (FELs) are well known as the most commonly found in breast pathology that can be diagnosed by core needle biopsy (CNB). FELs consist of fibroadenoma (FA) lesions and phyllodes tumor (PT). FELs have overlapping histological characteristics thereby complicating the distinction between FA and PT with an initial CNB. Therefore, our study aimed to differentiate the histological characteristics of FELs on CNB, and whether there was a correlation with an upgrade of diagnosis of PT on subsequent excisional specimens. A retrospective review of all FELs diagnosed by CNB in FELs identified patients at Khon Kaen University (Srinagarind Hospital) during six years (2013-2018) was conducted by three pathologists to confirm the diagnosis of the features of CNB and subsequent excisional specimens. Of 209 patients who were diagnosed with FELs by CNB, 76 cases received subsequent excision. The excisional specimens were reviewed for FA (52 of 76), and whether they were benign PT (16 of 76) or borderline PT (8 of 76). No malignant PT was identified in our study. Overall stromal cellularity (moderate and high degrees, 58.3 and 20.8 %; p< 0.001), stromal pleomorphism (moderate and high atypia, 66.7 and 4.2%; p< 0.001), and stromal overgrowth at 100x (87.5%; p<0.001) on CNB correlated markedly with an upgrade of PT diagnosis on subsequent excisional specimens. Our study provided evidence for the differentiation of FELs features on associated CNB with an upgrade PT diagnosis on subsequent excisional specimens. Hence, FELs diagnosed by CNB can be used for excision with a clear margin in the future.

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How to Cite
Intarawichian, P., Kanchana, K., Kunprom, W., Somintara, O., Koonmee, S., & Aphivatanasiri, C. (2022). Correlation between fibroepithelial lesions with breast core needle biopsy and surgical excision. Asia-Pacific Journal of Science and Technology, 27(05), APST–27. https://doi.org/10.14456/apst.2022.77
Section
Research Articles

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