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Updated: Mar 12, 2026
Comparative Lesions Analysis Through a Targeted Sequencing Approach
Published on: November 5, 2019
Clinicopathological and Molecular Characterization of Pediatric Breast Fibroepithelial Lesions: A Cohort Study
Jie Zhang1,2, Weimao Kong3, Longnv Bao1
1Department of Pathology, School of Basic Medicine, Qingdao University, Qingdao, China.
Insights
Pediatric breast fibroepithelial lesions (FELs) often present as a diagnostic continuum. Distinguishing fibroadenomas (FAs) from benign phyllodes tumors (PTs) showed limited clinical impact in this pediatric cohort.
Area of Science:
- Pediatric pathology
- Oncology
- Molecular diagnostics
Background:
- Fibroepithelial lesions (FELs) are uncommon in pediatric patients.
- Accurate distinction between fibroadenomas (FAs) and phyllodes tumors (PTs) is crucial for patient management.
Purpose of the Study:
- To characterize clinicopathological and molecular features of pediatric breast FELs.
- To evaluate the clinical relevance of differentiating FAs from PTs in children.
Main Methods:
- Retrospective analysis of 138 pediatric breast FELs.
- Pathologic evaluation, immunohistochemistry (CD34, Ki-67, p16), and molecular analysis (MED12, TERT).
Main Results:
- 133 FAs (96.4%) and 5 benign PTs (3.6%) were identified.
- MED12 mutations were associated with larger tumors (≥4 cm).
- No TERT promoter mutations were found; no recurrences observed, but new lesions developed.
Conclusions:
- Pediatric breast FELs may represent a diagnostic continuum.
- Distinguishing FAs from benign PTs has limited prognostic significance in pediatric cases.
Objective:
The aim of this study is to characterize the clinicopathological and molecular features of pediatric breast fibroepithelial lesions (FELs) and evaluate the diagnostic and clinical relevance of distinguishing fibroadenomas (FAs) from phyllodes tumors (PTs).
Methods:
We retrospectively analyzed 138 pediatric breast FELs. Pathologic evaluation, immunohistochemical staining, and Sanger sequencing of MED12 exon 2 and the TERT promoter were performed.
Results:
Of the 138 cases, 133 were diagnosed as FAs (96.4%) and five as benign PTs (3.6%). CD34, Ki-67, and p16 expression were correlated with mitotic activity. CD34 also associated with atypia, and Ki-67 with stromal overgrowth. Larger sized tumors (≥4 cm) had mutant MED12 (30/45 cases). No TERT promoter mutations were detected. During follow-up (range 17-153 months), no true recurrences occurred; though, 13 patients developed new lesions in other quadrants or contralateral breast.
Conclusions:
Pediatric FELs likely represent a diagnostic continuum. In this cohort, the distinction between FA and benign PT did not impact clinical outcome, suggesting limited prognostic significance.
