Fibroepithelial tumors of the breast including fibroadenomas and phylloides tumors arise from epithelial and stromal components of the terminal duct-lobular unit. Fibroadenoma is the commonest benign neoplasm of the female breast. These tumors are found as early as puberty. Mammary phylloides tumors are uncommon stromal-epithelial neoplasms and are divided into benign, borderline malignant and frankly malignant groups on the basis of their histological features.
The aim of this study is to evaluate the role of morphologic diagnosis in a series of fibroepithelial (biphasic) tumors of the breast including fibroadenoma and phylloides tumor, highlighting the morphological and Histopathological variants of fibroadenoma, and the most recent histological classification criteria of phylloides tumors.
PATIENTS AND METHODS:
This is a retrospective study including 250 cases of fibroepithelial tumors of the female breast, from October 2007 to September 2008. Cases were taken from private laboratories. All cases were excisional biopsy, the specimens were already fixed in 10% formalin and paraffin embedded. Sections of 4 microns were made from the paraffin blocks and stained with hematoxyllin and eosin stain and examined microscopically.
Two-hundred and fifty cases of mammary fibroepithelial tumors were reviewed in this study. The age of the patients ranged between 14-49 years, and the tumor size ranged between 1.5-20 cm. The cases were histologically classified into: 220(88%) cases of fibroadenoma(FA) and 30(12%) cases of phylloides tumor(PT). Additional morphological features of fibroadenoma were: fifteen(6.8%)cases juvenile fibroadenoma, infarction in eight(3.6%) cases, lactational changes in ten(4.5%) cases, multinucleated giant cells in the stroma in six(2.7%) cases, prominent myxoid changes in three(1.4%) cases, features of fibrocystic changes in the surrounding in 14(6.4%) cases, cellular stroma in eight(3.6%) cases, apocrine metaplasia in 26(11.9%) cases, hyalinization and calcification of the stroma in 14(6.4%) cases, presence of adipose tissue , muscle or cartilage in 18(8.2%) cases, atypical epithelial hyperplasia in four(1.8%) cases, and ordinary fibroadenomas (non-otherwise specific) in 94(42.7%) cases. Multiple fibroademnomas were found in 20(9.1%) cases. Histological classification of the phylloides tumors showed 20(66.7%) benign cases, six(20%) cases borderline malignant and four(13.3%) malignant cases.
Fibroadenoma is the commonest fibroepithelial tumor of female breast, phylloides tumor is an uncommon neoplasm which is usually benign but malignant variant exists.