Radiologic-Pathologic Correlation of Fibroepithelial Lesions: A Pictorial Review

Area of Science:

• Breast imaging and pathology
• Oncology
• Radiology and pathology collaboration

Background:

• Fibroepithelial lesions (FEL) represent a spectrum of breast masses with varying clinical behaviors.
• Distinguishing between benign and malignant potential is crucial for patient management.
• Imaging findings can be nonspecific, necessitating integrated diagnostic approaches.

Approach:

• Review of imaging characteristics (size, shape, margins, growth, echotexture) for differentiating fibroadenoma (FA) and phyllodes tumor (PT).
• Histopathological features (stromal cellularity, atypia, mitotic activity) are key discriminators.
• Emphasis on the collaborative role of radiologists and pathologists.

Key Points:

• Fibroadenoma (FA) typically presents as small, oval, circumscribed masses with homogeneous echotexture.
• Phyllodes tumors (PT) are often larger, with irregular shape, noncircumscribed margins, and heterogeneous echotexture.
• Histopathology reveals increased stromal cellularity, atypia, and mitotic activity in PT, unlike FA.

Conclusions:

• Accurate differentiation of nonmalignant FEL, including FA and PT, is essential for guiding clinical decisions.
• Radiological assessment combined with pathological evaluation improves diagnostic accuracy.
• Multidisciplinary collaboration ensures optimal management strategies for breast fibroepithelial lesions.