Objective: To determine whether there are significant differences between fibroadenomas and phyllodes tumours with regard to selected cytomorphological features. Study Design: A 10-year retrospective review was performed of patients who underwent excision of a fibroadenoma or phyllodes tumour and in whom a preoperative fine-needle aspiration was performed. The following cytological criteria were assessed: number of stromal and epithelial fragments, stromal-to-epithelial ratio, stromal cellularity, stromal borders, stromal atypia, and proportion of background wavy spindled cells. Patient age, tumour laterality, and tumour size were recorded. Results: Fifty fibroadenomas and 17 phyllodes tumours were included. Compared to phyllodes tumours, fibroadenomas had a larger number of epithelial fragments, a smaller number of stromal fragments, and a lower stromal-to-epithelial ratio. The stroma tended to be less cellular and less atypical compared to phyllodes tumours and the background cellular population contained fewer spindled cells. Conclusion: Fibroadenomas and phyllodes tumours differ with regard to various cytological features, aiding in their distinction on fine-needle aspiration biopsy.

1.
Cibas ES, Ducatman BS: Cytology: Diagnostic Principles and Clinical Correlates. Philadelphia, Saunders, 2009, p 233.
2.
Rosen PP: Rosen's Breast Pathology. Philadelphia, Wolters Kluwer Health/Lippincott Williams & Wilkins, 2009, pp 188-226.
3.
Lakhani SR; International Agency for Research on Cancer; World Health Organization: WHO Classification of Tumours of the Breast. Geneva, WHO, 2012, pp 141-147.
4.
Foxcroft LM, Evans EB, Porter AJ: Difficulties in the pre-operative diagnosis of phyllodes tumours of the breast: a study of 84 cases. Breast 2007;16:27-37.
5.
Simi U, Moretti D, Iacconi P, Arganini M, Roncella M, Miccoli P, et al: Fine needle aspiration cytopathology of phyllodes tumor: differential diagnosis with fibroadenoma. Acta Cytol 1988;32:63-66.
6.
Stanley MW, Tani EM, Rutqvist LE, Skoog L: Cystosarcoma phyllodes of the breast: a cytologic and clinicopathologic study of 23 cases. Diagn Cytopathol 1989;5:29-34.
7.
Dusenbery D, Frable WJ: Fine needle aspiration cytology of phyllodes tumor: potential diagnostic pitfalls. Acta Cytol 1992;36:215-221.
8.
Rao CR, Narasimhamurthy NK, Jaganathan K, Mukherjee G, Hazarika D: Cystosarcoma phyllodes:diagnosis by fine needle aspiration cytology. Acta Cytol 1992;36:203-207.
9.
Shimizu K, Masawa N, Yamada T, Okamoto K, Kanda K: Cytologic evaluation of phyllodes tumors as compared to fibroadenomas of the breast. Acta Cytol 1994;38:891-897.
10.
Shabb NS: Phyllodes tumor. Fine needle aspiration cytology of eight cases. Acta Cytol 1997;41:321-326.
11.
Deen SA, McKee GT, Kissin MW: Differential cytologic features of fibroepithelial lesions of the breast. Diagn Cytopathol 1999;20:53-56.
12.
Bhattarai S, Kapila K, Verma K. Phyllodes tumor of the breast: a cytohistologic study of 80 cases. Acta Cytol 2000;44:790-796.
13.
Krishnamurthy S, Ashfaq R, Shin HJ, Sneige N: Distinction of phyllodes tumor from fibroadenoma: a reappraisal of an old problem. Cancer 2000;90:342-349.
14.
Scolyer RA, Mckenzie PR, Achmed D, Soon Lee C: Can phyllodes tumours of the breast be distinguished from fibroadenomas using fine needle aspiration cytology? Pathology 2001;33:437-443.
15.
Veneti S, Manek S: Benign phyllodes tumour vs fibroadenoma: FNA cytological differentiation. Cytopathology 2001;12:321-328.
16.
Jayaram G, Sthaneshwar P: Fine-needle aspiration cytology of phyllodes tumors. Diagn Cytopathol 2002;26:222-227.
17.
Shimizu K, Korematsu M: Phyllodes tumor of the breast: a cytomorphologic approach based on evaluation of epithelial cluster architecture. Acta Cytol 2002;46:332-336.
18.
Bandyopadhyay R, Nag D, Mondal SK, Mukhopadhyay S, Roy S, Sinha SK: Distinction of phyllodes tumor from fibroadenoma: cytologists' perspective. J Cytol 2010;27:59-62.
19.
El Hag IA, Aodah A, Kollur SM, Attallah A, Mohamed AAE, Al-Hussaini H: Cytological clues in the distinction between phyllodes tumor and fibroadenoma. Cancer Cytopathol 2010;118:33-40.
20.
Shabalova IP, Chemeris GJ, Ermilova VD, Rodionova LM, Pavlikova NA, Syrjänen KJ: Phyllodes tumour: cytologic and histologic presentation of 22 cases, and immunohistochemical demonstration of p53. Cytopathology 1997;8:177-187.
21.
Komenaka IK, El-Tamer M, Pile-Spellman E, Hibshoosh H: Core needle biopsy as a diagnostic tool to differentiate phyllodes tumor from fibroadenoma. Arch Surg 2003;138:987-990.
22.
Jacklin RK, Ridgway PF, Ziprin P, Healy V, Hadjiminas D, Darzi A: Optimising preoperative diagnosis in phyllodes tumour of the breast. J Clin Pathol 2006;59:454-459.
23.
Adesoye T, Neuman HB, Wilke LG, Schumacher JR, Steiman J, Greenberg CC: Current trends in the management of phyllodes tumors of the breast. Ann Surg Oncol 2016;23:3199-3205.
24.
Page JE, Williams JE: The radiological features of phylloides tumour of the breast with clinico-pathological correlation. Clin Radiol 1991;44:8-12.
25.
Chao T-C, Lo Y-F, Chen S-C, Chen M-F: Sonographic features of phyllodes tumors of the breast. Ultrasound Obstet Gynecol 2002;20:64-71.
26.
Gatta G, Iaselli F, Parlato V, Di Grezia G, Grassi R, Rotondo A: Differential diagnosis between fibroadenoma, giant fibroadenoma and phyllodes tumour: sonographic features and core needle biopsy. Radiol Med 2011;116:905-918.
27.
Awad FM, Alsaeed M: Can breast MRI differentiate phyllodes breast tumors from fibroadenomas? Med J Cairo Univ 2009;77:231-235.
28.
Parker SJ, Harries SA: Phyllodes tumours. Postgrad Med J 2001;77:428-435.
29.
Rosa M, Mohammadi A, Masood S: The value of fine needle aspiration biopsy in the diagnosis and prognostic assessment of palpable breast lesions. Diagn Cytopathol 2012;40:26-34.
30.
Smith MJ, Heffron CC, Rothwell JR, Loftus BM, Jeffers M, Geraghty JG: Fine needle aspiration cytology in symptomatic breast lesions: still an important diagnostic modality? Breast J 2012;18:103-110.
31.
Nassar A: Core needle biopsy versus fine needle aspiration biopsy in breast: a historical perspective and opportunities in the modern era. Diagn Cytopathol 2011;39:380-388.
32.
Simsir A, Cangiarella J: Challenging breast lesions: pitfalls and limitations of fine-needle aspiration and the role of core biopsy in specific lesions. Diagn Cytopathol 2012;40:262-272.
33.
Nagar S, Iacco A, Riggs T, Kestenberg W, Keidan R: An analysis of fine needle aspiration versus core needle biopsy in clinically palpable breast lesions: a report on the predictive values and a cost comparison. Am J Surg 2012;204:193-198.
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