ArticleWorld journal of surgery2020
Fibroepithelial Lesions (FELs) of the Breast: Is Routine Excision Always Necessary?
Article in World journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Vacuum-assisted excision: a safe minimally invasive option for benign phyllodes tumor diagnosis and treatment-a systematic review and meta-analysis.Frontiers in oncology · 2024Pooled it
- Single-cell transcriptome sequencing revealing the microenvironment of breast fibroepithelial tumor.Biochemistry and biophysics reports · 2026Article
- Unusual site, familiar pathology: A case of fibroadenoma in ectopic breast tissue.Radiology case reports · 2025Article
- Malignant upgrade in lesions of uncertain malignant potential in the breast (B3 lesions) - is open excision always necessary?Breast cancer research and treatment · 2025Article
- De-escalating indications for excision when breast core needle biopsy returns fibroepithelial lesion-not further characterized.Breast cancer research and treatment · 2024Article
- Five-year follow-up after a single US-guided high intensity focused ultrasound treatment of breast fibroadenoma.Scientific reports · 2024Article
- Gene Expression Profiling of Fibroepithelial Lesions of the Breast.International journal of molecular sciences · 2023Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhen needle core biopsies (NCBs) of the breast reveal fibroepithelial lesions (FELs), excision is often performed to rule out a phyllodes tumor (PT), despite low malignancy rates. Consequently, the natural history of observed FELs is not well described. We analyzed the malignancy risk in excised FELs and the natural history of FELs undergoing active surveillance (AS).
methodsWe retrospectively studied the pathology and imaging records of 215 patients with FELs (n = 252) diagnosed on NCB. Incidence of growth was determined by Kaplan-Meier method.
resultsOf 252 FELs, 80% were immediately excised and 20% underwent AS. Of the excised FELs, 198 (98%) were benign: fibroadenoma (FA) or benign breast tissue in 137 (68%), benign PT in 59 (29%), or LCIS in 2 (1%). Borderline PT or malignant lesions were found in 4 (2%). On ultrasound, malignant and borderline PTs were larger than benign lesions [median 3.9 vs 1.3 cm, p = 0.006]. Fifty FELs underwent AS, with a median follow-up of 17 (range 2-79) months. The majority remained stable or decreased in size: at 2 years, only 35% increased in volume by ≥ 50%. Of those tumors undergoing AS that were later excised (n = 4), all were benign.
conclusionsAlmost all FELs (98%) were benign on surgical excision, and the majority undergoing AS remained stable, with benign pathology if later excised. Most FELs on NCB can be safely followed with US, with surgery reserved for patients with FELs that are large, symptomatic, or growing. This could spare most women with FELs unnecessary surgery.
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