Classification of fibroepithelial lesions of the breast in core needle biopsy with implications for further management
Rakha, Emad A Quinn, Cecily Raymond, Wendy Allison, Kimberly H Badve, Sunil S Brogi, Edi Callagy, Grace Charafe-Jauffret, Emmanuelle Chen, Chih Jung Chen, Yunn-Yi
Rakha, Emad A
Quinn, Cecily
Raymond, Wendy
Allison, Kimberly H
Badve, Sunil S
Brogi, Edi
Callagy, Grace
Charafe-Jauffret, Emmanuelle
Chen, Chih Jung
Chen, Yunn-Yi
Abstract
Fibroepithelial lesions (FELs) of the breast represent a diverse group of biphasic tumors with varying morphologies and clinical behavior. The classification of FELs is mainly based on a constellation of diagnostic criteria, and intralesional heterogeneity is not uncommon. Therefore, reporting FELs in a core needle biopsy (CNB) with limited tissue material can be challenging as not all the features may be represented for assessment. Differentiating a classic fibroadenoma from a well-sampled phyllodes tumor (PT) is generally straightforward. However, cellular fibroadenoma, morphologically heterogeneous benign PT, and myoid hamartoma can overlap histologically. Accurate grading of PT is also challenging on CNB and carries significant management implications. In this article, we provide an overview and propose a pragmatic approach to reporting FELs on CNB, particularly for lesions with overlapping features. Guidance using the UK/European "B" classification of FELs alongside descriptive reporting of the various lesions, is also presented to aid in management decisions.
MIDER Authors
Date
2025-02-11
Type
Article
Subject
Classification, Biopsy, Biopsy, needle, Classification
Collections
Citation
Rakha EA, Quinn C, Raymond W, Allison KH, Badve SS, Brogi E, Callagy G, Charafe-Jauffret E, Chen CJ, Chen YY, Collins LC, Cserni G, Djerroudi L, Jaffer S, Foschini MP, Gobbi H, Gudi M, Harada O, Kulka J, Kuroda H, Lakhani SR, Li X, Moriya T, O'Toole SA, Pinder SE, Provenzano E, Sahin AA, Schmitt F, Shaaban AM, Siziopikou KP, Tang P, Tse GM, Varga Z, Vincent-Salomon A, Wen H, Yamaguchi R, Yang W, Fox SB, Schnitt SJ, Ellis IO, Tan PH. Classification of Fibroepithelial Lesions of the Breast in Core Needle Biopsy With Implications for Further Management. Mod Pathol. 2025 May;38(5):100734. doi: 10.1016/j.modpat.2025.100734. Epub 2025 Feb 11.
Journal / Source Title
Modern Pathology
DOI
10.1016/j.modpat.2025.100734
PMID
39947480
Publisher
Elsevier
Publisher’s URL
https://www.sciencedirect.com/journal/modern-pathology
https://www.nature.com/modpathol/
https://www.nature.com/modpathol/