Fibroepthelial lesions are one of the most common benign breast disease seen in day today practice. They comprise of a wide spectrum of tumors ranging from fibroadenoma to infrequent phyllodes tumor. Evaluation of fibroepithelial lesions on FNA material or biopsy material may be sometimes under interpreted as both fibroadenoma and phylloides tumor have few common morphological features. So a detailed histopathological study is necessary to identify the hurdles in diagnosis and management of patient. This study was conducted with an aim to stratify and classify various fibroepithelial lesions, to classify phyllodes tumor according to newer WHO guidelines, to study interobserver variations in diagnosing phyllodes tumor and other associated morphological features in fibroepithelial lesion.
Materials and Methods: This was retrospective study conducted in Department of Pathology, Hassan Institute of Medical Sciences, Hassan. The study was done on all breast biopsy samples received from the year January 2015 to April 2020 for a duration of 5years. Archived slides were reviewed in detail by three pathologists and fibroepithelial lesions were classified according to WHO classification of tumors of breast 2019.
Results: A total of 200 fibroepithelial lesions of breast were studied. 180 cases were fibroadenoma, 18 cases were phyllodes tumor and 2 cases were benign fibroepithelial neoplasm. Interobserver variation was seen in 6 cases of benign phyllodes tumor, whereas no ambiguity was seen in diagnosis of fibroadenomas.
Conclusion: Over diagnosis fibroadenomas as phyllodes tumor may have been prevented, if standard criteria were in use. Fibroadenoma and benign phyllodes tumor can be difficult to distinguish in some cases where focal leaf like growth pattern and hypercellularity can be seen. It is a good practice to evaluate the lesion as whole to come to a definitive diagnosis rather than emphasising on focal features.