Jung Jaehag, Kang Eunyoung, Chae Su Min, Kim Hyojin, Park So Yeon, Yun Bo La, Kim Sun Mi, Jang Mijung, Kim Sung-Won, Kim Eun-Kyu
1 Department of Surgery, Eulji University College of Medicine, Daejeon, Korea.
2 Department of Surgery, Seoul National University College of Medicine, Seoul National University, Bundang Hospital, Seongnam, Korea.
Int J Surg Pathol. 2018 Dec;26(8):684-692. doi: 10.1177/1066896918775525. Epub 2018 May 18.
Surgical excision is recommended for complete evaluation of cellular fibroepithelial lesions identified from core needle biopsy. The purpose of this study was to determine factors associated with phyllodes tumor among cellular fibroepithelial lesions from core biopsies and develop a scoring system to predict the risk of phyllodes tumor.
We retrospectively reviewed clinical data of 169 breast lesions that were diagnosed as cellular fibroepithelial lesions from core needle biopsy at the Seoul National University Bundang Hospital between March 2005 and January 2013. The clinical, histopathologic, and radiologic characteristics were compared between phyllodes tumors and fibroadenomas during the final diagnosis after surgical excision.
Of the 169 lesions, 17 were observed and 152 were surgically removed. After excision, final pathology revealed 60 (39.5%) fibroadenomas and 92 (60.5%) phyllodes tumors. Multivariate analysis demonstrated that age (≥40 years), stromal overgrowth, and stromal cellularity were independent factors associated with phyllodes tumors. A scoring system was developed based on a multivariate logistic regression model, and the area under the receiver operating characteristic curve was 0.828 (95% confidence interval = 0.763-0.893).
The scoring system will help clinicians make appropriate treatment for patients with cellular fibroepithelial lesions on core needle biopsy.
对于经粗针活检确诊的细胞性纤维上皮性病变，建议手术切除以进行全面评估。本研究的目的是确定粗针活检的细胞性纤维上皮性病变中与叶状肿瘤相关的因素，并建立一个评分系统来预测叶状肿瘤的风险。
我们回顾性分析了2005年3月至2013年1月在首尔国立大学盆唐医院经粗针活检诊断为细胞性纤维上皮性病变的169例乳腺病变的临床资料。在手术切除后的最终诊断中，比较了叶状肿瘤和纤维腺瘤的临床、组织病理学和放射学特征。
169例病变中，17例进行了观察，152例进行了手术切除。切除后，最终病理显示60例（39.5%）为纤维腺瘤，92例（60.5%）为叶状肿瘤。多因素分析表明，年龄（≥40岁）、间质过度生长和间质细胞密度是与叶状肿瘤相关的独立因素。基于多因素逻辑回归模型建立了一个评分系统，受试者工作特征曲线下面积为0.828（95%置信区间=0.763-0.893）。
该评分系统将有助于临床医生对粗针活检诊断为细胞性纤维上皮性病变的患者进行适当的治疗。
