Diagnostic management of fibroepithelial lesions: When is excision indicated?

Fibroepithelial tumors of the breast are characterized by having both epithelial and stromal components. This group of tumors includes benign fibroadenomas (FA) and phyllodes tumors (PT), which can have benign, borderline, or malignant forms. Differentiating between a cellular FA and a benign PT can be challenging. It is important to establish a differential diagnosis with other benign and malignant breast lesions in both PTs and FAs. The treatment approach and prognosis for both FAs and PTs will depend on their specific pathological characteristics detected in the core biopsy of the lesion. The diagnostic and therapeutic challenges faced by clinicians lie in accurately characterizing these lesions and determining which cases warrant surgical excision. A thorough evaluation of clinical, radiological, and histological features is crucial in making these decisions and ensuring optimal patient outcomes. Close multidisciplinary collaboration between clinicians, radiologists, and pathologists is essential in making these decisions and ensuring optimal patient care.