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Journals / Journal of Medicine and Palliative Care / 2026 / Volume: 7 Issue: 5

Unexpected malignancy and phyllodes tumors among presumed benign breast masses: a single-center retrospective cohort study

Berk Topaloğlu(SBÜ Van Eğitim ve Araştırma Hastanesi)0009-0002-3350-1496
İbrahim Doğan(SBÜ Van Eğitim ve Araştırma Hastanesi)0000-0001-7413-1837
Pages
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Publication Date
2026-10-25
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Malignancy occurred in about 2% of masses without documented suspicious findings, largely those without imaging records; older age identified females at higher risk, and histopathological examination of all excised specimens remains warranted.

📌 3 Key Takeaways

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Objective & Hypothesis:Aims: We aimed to determine the rate of unexpected malignancy and phyllodes tumor, and factors associated with malignancy, among females undergoing surgery for a presumed benign breast mass.
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Key Findings & Data:Methods: This single-center retrospective cohort study included females who underwent excision of a presumed benign breast mass in 2015-2025, identified from operative records of benign breast excision.
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Conclusion & Impact:Conclusion: Malignancy occurred in about 2% of masses without documented suspicious findings, largely those without imaging records; older age identified females at higher risk, and histopathological examination of all excised specimens remains warranted.
🔬Design:Research Article
📍Scope:2015-2025 Verileri
⚙️Variables:Fibroadenoma · breast neoplasms · phyllodes tumor

Abstract

Aims: We aimed to determine the rate of unexpected malignancy and phyllodes tumor, and factors associated with malignancy, among females undergoing surgery for a presumed benign breast mass. Methods: This single-center retrospective cohort study included females who underwent excision of a presumed benign breast mass in 2015-2025, identified from operative records of benign breast excision. Masses with a preoperative malignant (B5) biopsy were excluded; because a preoperative diagnosis of malignancy would have mandated oncological surgery, every malignancy on final histopathology was unexpected. Associations with malignancy were assessed by Firth penalized-likelihood regression; sensitivity analyses were restricted to masses without any documented suspicious preoperative finding. Results: Among 513 breast masses in 508 females (median age 27 years), unexpected malignancy occurred in 15/513 (2.9%, 95% confidence interval [CI] 1.6-4.8) and phyllodes tumor in 14/513 (2.7%); none of the 14 was malignant. Malignancy was associated with age ≥40 years (9.8% vs 1.0%; odds ratio 10.0, 95% CI 3.3–30.5). In exploratory analyses with few events, every malignancy with available ultrasonography (US) had a suspicious feature (negative predictive value 100%, 95% CI 98.6-100). Malignancy occurred in 9/418 (2.2%, 95% CI 1.0-4.0) without documented suspicious findings (all nine without an available US report) and in 0/41 with concordant benign imaging and biopsy. No benign (B2) biopsy was upgraded to malignancy (0/85). Conclusion: Malignancy occurred in about 2% of masses without documented suspicious findings, largely those without imaging records; older age identified females at higher risk, and histopathological examination of all excised specimens remains warranted.

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Topaloğlu, B., Doğan, İ. (2026). Unexpected malignancy and phyllodes tumors among presumed benign breast masses: a single-center retrospective cohort study. Journal of Medicine and Palliative Care, Volume: 7 Issue: 5. https://ajindex.com/articles/1668101

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References (24)

  1. Tan BY, Acs G, Apple SK, et al. Phyllodes tumours of the breast: a consensus review. Histopathology. 2016;68(1):5-21. doi:10.1111/his.12876
  2. Johansson A, Christakou AE, Iftimi A, et al. Characterization of benign breast diseases and association with age, hormonal factors, and family history of breast cancer among women in Sweden. JAMA Netw Open. 2021;4(6):e2114716. doi:10.1001/jamanetworkopen.2021.14716
  3. Diaz NM, Palmer JO, McDivitt RW. Carcinoma arising within fibroadenomas of the breast. A clinicopathologic study of 105 patients. Am J Clin Pathol. 1991;95(5):614-622. doi:10.1093/ajcp/95.5.614
  4. Pick PW, Iossifides IA. Occurrence of breast carcinoma within a fibroadenoma. A review. Arch Pathol Lab Med. 1984;108(7):590-594.
  5. Lissidini G, Mulè A, Santoro A, et al. Malignant phyllodes tumor of the breast: a systematic review. Pathologica. 2022;114(2):111-120. doi:10.32074/1591-951X-754
  6. Sood R, Rositch AF, Shakoor D, et al. Ultrasound for breast cancer detection globally: a systematic review and meta-analysis. J Glob Oncol. 2019;5:1-17. doi:10.1200/JGO.19.00127
  7. Dillon MF, Quinn CM, McDermott EW, O’Doherty A, O’Higgins N, Hill AD. Needle core biopsy in the diagnosis of phyllodes neoplasm. Surgery. 2006;140(5):779-784. doi:10.1016/j.surg.2006.03.022
  8. Xu L, Luo S, Mao Q, et al. Breast carcinoma arising in a fibroadenoma: a case series of 16 patients and review of the literature. Oncol Lett. 2024; 27(1):39. doi:10.3892/ol.2023.14172
  9. Pruthi S. Detection and evaluation of a palpable breast mass. Mayo Clin Proc. 2001;76(6):641-647. doi:10.4065/76.6.641
  10. Kerlikowske K, Smith-Bindman R, Ljung BM, Grady D. Evaluation of abnormal mammography results and palpable breast abnormalities. Ann Intern Med. 2003;139(4):274-284. doi:10.7326/0003-4819-139-4-200308190-00010
  11. Ware AD, Argani P, Cimino-Mathews A. Accuracy and clinical implications of pre-operative breast core needle biopsy diagnoses of fibroepithelial neoplasms and sarcomatoid carcinomas. Breast Cancer Res Treat. 2019;178(1):51-56. doi:10.1007/s10549-019-05350-5
  12. Yang X, Kandil D, Cosar EF, Khan A. Fibroepithelial tumors of the breast: pathologic and immunohistochemical features and molecular mechanisms. Arch Pathol Lab Med. 2014;138(1):25-36. doi:10.5858/arpa.2012-0443-RA
  13. Slodkowska E, Nofech-Mozes S, Xu B, et al. Fibroepithelial lesions of the breast: a comprehensive morphological and outcome analysis of a large series. Mod Pathol. 2018;31(7):1073-1084. doi:10.1038/s41379-018-0032-8
  14. Hong AS, Rosen EL, Soo MS, Baker JA. BI-RADS for sonography: positive and negative predictive values of sonographic features. AJR Am J Roentgenol. 2005;184(4):1260-1265. doi:10.2214/ajr.184.4.01841260
  15. Badu-Peprah A, Otoo OK, Amamoo M, Quarshie F, Adomako B. Breast Imaging Reporting And Data System for sonography: positive and negative predictive values of sonographic features in Kumasi, Ghana. Transl Oncol. 2024;45:101976. doi:10.1016/j.tranon.2024.101976
  16. Tadesse GF, Tegaw EM, Abdisa EK. Diagnostic performance of mammography and ultrasound in breast cancer: a systematic review and meta-analysis. J Ultrasound. 2023;26(2):355-367. doi:10.1007/s40477-022-00755-3
  17. Houssami N, Ciatto S, Ellis I, Ambrogetti D. Underestimation of malignancy of breast core-needle biopsy: concepts and precise overall and category-specific estimates. Cancer. 2007;109(3):487-495. doi:10.1002/cncr.22435
  18. Willers N, Neven P, Floris G, et al. The upgrade risk of B3 lesions to (pre)invasive breast cancer after diagnosis on core needle or vacuum assisted biopsy. A Belgian national cohort study. Clin Breast Cancer. 2023;23(4): e273-e280. doi:10.1016/j.clbc.2023.03.006
  19. Elfgen C, Leo C, Kubik-Huch RA, et al. Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions). Virchows Arch. 2023;483(1):5-20. doi:10.1007/s00428-023-03566-x
  20. Ciatto S, Houssami N, Ambrogetti D, et al. Accuracy and underestimation of malignancy of breast core needle biopsy: the Florence experience of over 4000 consecutive biopsies. Breast Cancer Res Treat. 2007;101(3):291-297. doi:10.1007/s10549-006-9289-6
  21. Rubio IT, Wyld L, Marotti L, et al. European guidelines for the diagnosis, treatment and follow-up of breast lesions with uncertain malignant potential (B3 lesions) developed jointly by EUSOMA, EUSOBI, ESP (BWG) and ESSO. Eur J Surg Oncol. 2024;50(1):107292. doi:10.1016/j.ejso.2023.107292
  22. Rosenberger LH, White RL, Tafra L, et al. American Society of Breast Surgeons and Society of Breast Imaging 2025 guidelines for the management of benign breast fibroepithelial lesions. JAMA Surg. 2025; 160(12):1378-1385. doi:10.1001/jamasurg.2025.4392
  23. Rakha EA, Quinn C, Raymond W, et al. Classification of fibroepithelial lesions of the breast in core needle biopsy with implications for further management. Mod Pathol. 2025;38(5):100734. doi:10.1016/j.modpat.2025.100734
  24. Elnahas W, Metwally IH, Bonna K, et al. Fibroadenoma of the breast; incidence of malignancy and indicators for surgical intervention: an analysis of 1392 patients. Breast Dis. 2022;41(1):421-426. doi:10.3233/BD-210074