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
Affiliation
University of Nottingham; Hamad Medical Corporation; St. Vincent's University Hospital; Flinders Medical Centre; Clinpath Pathology; Stanford Medicine; Emory University; Memorial Sloan Kettering Cancer Center; University of Galway; Aix Marseille Université; Taichung Veterans General Hospital; Chung Shan Medical University; UCSF Medical Center; Beth Israel Deaconess Medical Center; Harvard Medical School; Bács-Kiskun County Teaching Hospital; University of Szeged; Institut Curie; Northwell Health Lenox Hill Hospital; University of Bologna; Federal University of Triangulo Mineiro; KK Women's and Children Hospital; Kameda General Hospital; Semmelweis University Budapest; Eurofins Medserv Ltd; Tokyo Women's Medical University Adachi Medical Center; University of Queensland; Pathology Queensland; Kawasaki Medical School; University of Sydney; Royal Prince Alfred Hospital; Guy's and St Thomas' NHS Foundation Trust; Cambridge University Hospitals NHS Foundation Trust; University of Texas; Porto University; University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; Northwestern University; Loyola University Medical Center; Chinese University of Hong Kong; University Hospital Zurich; Nagasaki University Hospital; Fudan University Shanghai Cancer Center; University of Melbourne; Brigham and Women's Hospital; Nottingham University Hospitals NHS Trust; Royal Square Medical Centre
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Publication date
2025-02-11
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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.
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.
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Article