E1298. Fibroepithelial Lesions: Diagnostic Challenges and Management Dilemmas
Authors
Rachel Miceli;
New York University Langone Health
Osvaldo Hernandez;
New York University Langone Health
Cecilia Mercado;
New York University Langone Health
Beatriu Reig;
New York University Langone Health
Chloe Chhor;
New York University Langone Health
Background
Mammary fibroepithelial lesions are commonly encountered in breast imaging. The spectrum of fibroepithelial lesions in the breast is broad, ranging from benign entities such fibroadenomas, to malignant entities such as malignant phyllodes. It is important for radiologists to be familiar with the full spectrum of fibroepithelial lesions because diagnosis of specific fibroepithelial lesion subtype involves radiology-pathology correlation, and management of these lesions varies from routine follow up to surgical excision.
Educational Goals / Teaching Points
The purpose of this exhibit is to describe the spectrum and imaging characteristics of fibroepithelial lesions, review radiology-pathology concordance for fibroepithelial lesions, discuss management considerations for fibroepithelial lesions, illustrate potential fibroepithelial mimics and differential considerations, identify tips to help differentiate fibroepithelial lesions over other pathologic considerations as well as pitfalls in diagnosis.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit is a case-based review of imaging manifestations, radiology-pathology correlation, and management of fibroepithelial lesions in the breast. This exhibit will include cases of fibroadenomas (complex, myxoid, cellular,) phyllodes tumors (benign, borderline, malignant,) and other fibroepithelial lesions (lactational adenoma [LT], tubular adenoma, nodular sclerosing adenosis, diabetic mastopathy, fibrous tumor, desmoid tumor, pseudoangiomatous stromal hyperplasia [PASH.]) Mammogram, ultrasound, MRI, and PET/CT will be used to demonstrate imaging characteristics of these lesions. Additionally, the exhibit will provide examples of other similar-appearing entities in the differential diagnosis, and provide clues to prevent potential diagnostic pitfalls.
Conclusion
The diagnostic work-up and management of fibroepithelial lesions in the breast remains a challenge in which radiologists play an important role. This educational exhibit reviews the imaging findings and management of fibroepithelial lesions in the breast and describes mimics and pitfalls that radiologists may face when encountering these cases.
