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Fibromatosis of the Breast: Diagnostic Accuracy of Core Needle Biopsy.

Abstract Fibromatosis of the breast is an uncommon neoplasm with potential for local recurrence. Treatment has traditionally been surgical excision with current trends toward conservative management. Given the option of observation after diagnosis by core needle biopsy (CNB), we sought to evaluate the accuracy of CNB for diagnosing fibromatosis.
PMID
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Authors

Mayor MeshTerms
Keywords

Breast pathology

CD34

Core needle biopsy

Desmoid

Fibromatosis

β-catenin

Journal Title american journal of clinical pathology
Publication Year Start




PMID- 28821190
OWN - NLM
STAT- MEDLINE
DA  - 20170819
DCOM- 20170906
LR  - 20170906
IS  - 1943-7722 (Electronic)
IS  - 0002-9173 (Linking)
VI  - 148
IP  - 3
DP  - 2017 Sep 01
TI  - Fibromatosis of the Breast: Diagnostic Accuracy of Core Needle Biopsy.
PG  - 243-250
LID - 10.1093/ajcp/aqx065 [doi]
AB  - Objectives: Fibromatosis of the breast is an uncommon neoplasm with potential for
      local recurrence. Treatment has traditionally been surgical excision with current
      trends toward conservative management. Given the option of observation after
      diagnosis by core needle biopsy (CNB), we sought to evaluate the accuracy of CNB 
      for diagnosing fibromatosis. Methods: We identified a total of 31 cases in which 
      fibromatosis had been diagnosed or included in the differential diagnosis on a
      CNB, an excision, or both. Morphology and immunohistochemical results were
      reviewed. Results: Aberrant nuclear immunoreactivity for beta-catenin and absent 
      staining for CD34 were the most useful studies to diagnose fibromatosis, and one 
      or both were performed in 21 (68%) cases. High molecular weight cytokeratins and 
      p63 were helpful to exclude spindle cell carcinoma. Of 26 cases confirmed as
      fibromatosis on excision, 22 (85%) were diagnosed as fibromatosis or fibromatosis
      was favored in the differential diagnosis on CNB. More frequent use of
      immunohistochemistry would likely have resulted in a greater number of definitive
      diagnoses. Fibromatosis was rarely mistaken for other nonmalignant stromal
      lesions, with no cases misdiagnosed as carcinoma. Conclusions: CNB can be an
      accurate method of diagnosing fibromatosis, allowing observation for a select
      group of patients.
FAU - Kuba, M Gabriela
AU  - Kuba MG
AD  - Department of Pathology.
FAU - Lester, Susan C
AU  - Lester SC
AD  - Department of Pathology.
FAU - Giess, Catherine S
AU  - Giess CS
AD  - Division of Breast Imaging, Department of Radiology, Brigham and Women's Hospital
      and Harvard Medical School, Boston, MA.
FAU - Bertagnolli, Monica M
AU  - Bertagnolli MM
AD  - Division of Surgical Oncology, Department of Surgery, Dana Farber-Cancer
      Institute, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
FAU - Wieczorek, Tad J
AU  - Wieczorek TJ
AD  - Department of Pathology, Brigham and Women's Faulkner Hospital, Boston, MA.
FAU - Brock, Jane E
AU  - Brock JE
AD  - Department of Pathology.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Am J Clin Pathol
JT  - American journal of clinical pathology
JID - 0370470
RN  - 68238-35-7 (Keratins)
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biopsy, Large-Core Needle
MH  - Breast Neoplasms/*diagnosis/metabolism/pathology
MH  - Diagnosis, Differential
MH  - Female
MH  - Fibroma/*diagnosis/metabolism/pathology
MH  - Humans
MH  - Immunohistochemistry
MH  - Keratins/metabolism
MH  - Middle Aged
MH  - Sensitivity and Specificity
MH  - Young Adult
OTO - NOTNLM
OT  - Breast pathology
OT  - CD34
OT  - Core needle biopsy
OT  - Desmoid
OT  - Fibromatosis
OT  - beta-catenin
EDAT- 2017/08/20 06:00
MHDA- 2017/09/07 06:00
CRDT- 2017/08/20 06:00
AID - 4056849 [pii]
AID - 10.1093/ajcp/aqx065 [doi]
PST - ppublish
SO  - Am J Clin Pathol. 2017 Sep 1;148(3):243-250. doi: 10.1093/ajcp/aqx065.