Patient with Fibroadenoma on Biopsy, Found to have Phyllodes on Final Pathology: A Case Presentation
Article Sidebar
Main Article Content
Abstract
Distinguishing between fibroadenomas and phyllodes tumors is a challenge in breast surgery, despite advances in both radiology and pathology. In this case report, we analyze a patient presenting with a breast mass with multiple core needle biopsy results consistent with fibroadenoma, who underwent enucleation and was found to have phyllodes tumor on final pathology, thereby requiring surgical re-excision. This case report highlights the importance of patient clinical presentation in differentiating fibroadenomas and phyllodes tumors and explores how to achieve appropriate margins upon surgical re-excision after prior enucleation of phyllodes tumor via ultrasound localization of a seroma.
Article Details
Copyright (c) 2023 Singh N, et al.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The Archives of Case Reports is committed in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. In order to use the Open Access paradigm to the maximum extent in true terms as free of charge online access along with usage right, we grant usage rights through the use of specific Creative Commons license.
License: Copyright © 2017 - 2025 | 
Open Access by Archives of Case Reports is licensed under a Creative Commons Attribution 4.0 International License. Based on a work at Heighten Science Publications Inc.
With this license, the authors are allowed that after publishing with the journal, they can share their research by posting a free draft copy of their article to any repository or website.
Compliance 'CC BY' license helps in:
| Permission to read and download | ✓ |
| Permission to display in a repository | ✓ |
| Permission to translate | ✓ |
| Commercial uses of manuscript | ✓ |
'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.
Pareja F, Geyer FC, Kumar R, Selenica P, Piscuoglio S, Ng CKY, Burke KA, Edelweiss M, Murray MP, Brogi E, Weigelt B, Reis-Filho JS. Phyllodes tumors with and without fibroadenoma-like areas display distinct genomic features and may evolve through distinct pathways. NPJ Breast Cancer. 2017 Oct 12;3:40. doi: 10.1038/s41523-017-0042-6. PMID: 29043292; PMCID: PMC5638820.
Tan BY, Acs G, Apple SK, Badve S, Bleiweiss IJ, Brogi E, Calvo JP, Dabbs DJ, Ellis IO, Eusebi V, Farshid G, Fox SB, Ichihara S, Lakhani SR, Rakha EA, Reis-Filho JS, Richardson AL, Sahin A, Schmitt FC, Schnitt SJ, Siziopikou KP, Soares FA, Tse GM, Vincent-Salomon A, Tan PH. Phyllodes tumours of the breast: a consensus review. Histopathology. 2016 Jan;68(1):5-21. doi: 10.1111/his.12876. PMID: 26768026; PMCID: PMC5027876.
Oprić S, Oprić D, Gugić D, Granić M. Phyllodes tumors and fibroadenoma common beginning and different ending. Coll Antropol. 2012 Mar;36(1):235-41. PMID: 22816226.
Wiratkapun C, Piyapan P, Lertsithichai P, Larbcharoensub N. Fibroadenoma versus phyllodes tumor: distinguishing factors in patients diagnosed with fibroepithelial lesions after a core needle biopsy. Diagn Interv Radiol. 2014 Jan-Feb;20(1):27-33. doi: 10.5152/dir.2013.13133. PMID: 24356293; PMCID: PMC4463252.
Tummidi S, Kothari K, Agnihotri M, Naik L, Sood P. Fibroadenoma versus phyllodes tumor: a vexing problem revisited! BMC Cancer. 2020 Jul 13;20(1):648. doi: 10.1186/s12885-020-07129-0. PMID: 32660435; PMCID: PMC7359567.
Duman L, Gezer NS, Balcı P, Altay C, Başara I, Durak MG, Sevinç AI. Differentiation between Phyllodes Tumors and Fibroadenomas Based on Mammographic Sonographic and MRI Features. Breast Care (Basel). 2016 Apr;11(2):123-7. doi: 10.1159/000444377. Epub 2016 Mar 23. PMID: 27239174; PMCID: PMC4881274.
Wurdinger S, Herzog AB, Fischer DR, Marx C, Raabe G, Schneider A, Kaiser WA. Differentiation of phyllodes breast tumors from fibroadenomas on MRI. AJR Am J Roentgenol. 2005 Nov;185(5):1317-21. doi: 10.2214/AJR.04.1620. PMID: 16247156.
Niu S, Huang J, Li J, Liu X, Wang D, Wang Y, Shen H, Qi M, Xiao Y, Guan M, Li D, Liu F, Wang X, Xiong Y, Gao S, Wang X, Yu P, Zhu J. Differential diagnosis between small breast phyllodes tumors and fibroadenomas using artificial intelligence and ultrasound data. Quant Imaging Med Surg. 2021 May;11(5):2052-2061. doi: 10.21037/qims-20-919. PMID: 33936986; PMCID: PMC8047381.
Stoffel E, Becker AS, Wurnig MC, Marcon M, Ghafoor S, Berger N, Boss A. Distinction between phyllodes tumor and fibroadenoma in breast ultrasound using deep learning image analysis. Eur J Radiol Open. 2018 Sep 24;5:165-170. doi: 10.1016/j.ejro.2018.09.002. PMID: 30258856; PMCID: PMC6154513.
Zhang L, Yang C, Pfeifer JD, Caprioli RM, Judd AM, Patterson NH, Reyzer ML, Norris JL, Maluf HM. Histopathologic, immunophenotypic, and proteomics characteristics of low-grade phyllodes tumor and fibroadenoma: more similarities than differences. NPJ Breast Cancer. 2020 Jun 26;6:27. doi: 10.1038/s41523-020-0169-8. PMID: 32613078; PMCID: PMC7319981.
Komenaka IK, El-Tamer M, Pile-Spellman E, Hibshoosh H. Core needle biopsy as a diagnostic tool to differentiate phyllodes tumor from fibroadenoma. Arch Surg. 2003 Sep;138(9):987-90. doi: 10.1001/archsurg.138.9.987. PMID: 12963656.
Mangi AA, Smith BL, Gadd MA, Tanabe KK, Ott MJ, Souba WW. Surgical management of phyllodes tumors. Arch Surg. 1999 May;134(5):487-92; discussion 492-3. doi: 10.1001/archsurg.134.5.487. PMID: 10323420.
Guillot E, Couturaud B, Reyal F, Curnier A, Ravinet J, Laé M, Bollet M, Pierga JY, Salmon R, Fitoussi A; Breast Cancer Study Group of the Institut Curie. Management of phyllodes breast tumors. Breast J. 2011 Mar-Apr;17(2):129-37. doi: 10.1111/j.1524-4741.2010.01045.x. Epub 2011 Jan 19. PMID: 21251125.
Simpson A, Li P, Dietz J. Diagnosis and management of phyllodes tumors of the breast. Annals of Breast Surgery. 2021; 5. https://abs.amegroups.org/article/view/6572
Nguyen QD, Krider SO, Roberts JT, Posleman Monetto FE, He J. Fibroepithelial Lesion Initially Believed to Be Fibroadenoma, but Interval Growth Consistent With Phyllodes Tumor. Cureus. 2020 Sep 10;12(9):e10363. doi: 10.7759/cureus.10363. PMID: 33062486; PMCID: PMC7549856.