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Diagnosed fibroadenoma, advised lumpectomy. Could it be phyllodes ?

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Gastroenterologist, Surgical
Practicing since : 1989
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I had a 12 gauge vacuum assisted core needle biopsy April 11th because my BIRADs were Suspicious on two areas. They took 3 samples of each lump. The results came back as follows: Left Breast nodule, 5:00 - Fibroepithelial lesion with local exaggerated intracanalicular growth pattern. Differential Diagnosis includes finbroadenoma vs benign phyllodes tumor, morphologic features favor the first impressions,. The other one they weren't worried about at all. Clinical correclation indicated. What does this mean? Is it likely a fibroadenoma? Two doctors said benign/watch and wait-- and referred me to a surgeon, not even thinking she would take it out. The surgeon advised she can't tell me for sure until it is completely taken out, and my lumpectomy isn't scheduled until May 18th. Now I am a nervous wreck with this waiting game. Im fearing phyllodes...

Can anyone tell me if I have reason to worry . oh, my lump is 12mm x 9 x 16mm. I have previous fibroadenomas since I was 19 that have not I do have a history of fibroids..this is a new one since I had a child over two years ago. I am now 42. Ive attached the preliminary core biopsy pathology report.

Im looking to get a little peace of mind since I have to wait until May 18 for the lumpectomies and the final biopsy of those lumps once taken out. Are the odds good that report will show the same, no cancer? Help!!!!
Posted Mon, 21 May 2012 in Breast Cancer
Answered by Dr. Ketan Vagholkar 13 hours later

Thanks for the query.

I can understand the anxiety which you are experiencing. But you just don't have to worry. I have read your histopathology report and would like to make some comments.

1. Regarding the A part of the report, it is a fibroadenoma of the intracanalicular type. Now phyllodes tumor histologically resembles an intracanalicular fibroadenoma. But over and above the features of a fibroadenoma there needs to be increased stromal proliferation and dysplasia which are absent in your case. So histologically it is not a phyllodes tumor.
Many a time diagnosis may be equivocal. In such cases due consideration is given to clinical features. That is the main reason why it was written to correlate clinically. Clinical correlation in your case considering the small size of the lump goes against the diagnosis of phyllodes tumor. In addition phyllodes tumor grows very rapidly and usually occupies the whole breast.

2. Regarding the B part of the report it is purely a fibroadenomatous lesion which is always benign or non malignant.

From you history and the histopathological report sent by you are suffering from a condition called fibrocystic disease of the breast. Therefore your attending doctor has advised you to adopt a wait and watch policy.

So you can safely wait until the date of removal.

I hope this clears your doubts and allays your fear of malignancy. Let me know if you have any more concern.

With Regards
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