AB164. SOH21AS161. Ductal carcinoma in situ in fibroepithelial breast lesions, can it be diagnosed preoperatively?—Review of literature and case report
General Poster Session

AB164. SOH21AS161. Ductal carcinoma in situ in fibroepithelial breast lesions, can it be diagnosed preoperatively?—Review of literature and case report

Lauren Nicole Crone, Johnathon Harris, Sami Medani Abd Elwahab, Abeeda Butt, Arnold Donald Konrad Hill

Department of Breast and General Surgery, Beaumont Hospital, Dublin, Ireland

Background: Ductal carcinoma in situ (DCIS) rarely forms from within a phyllodes tumour. It is crucial to identify the presence of DCIS in these lesions preoperatively as surgery would involve clear margins as opposed to simple lumpectomies for benign phyllodes tumours. We aimed to review published literature and report a case.

Methods: A case of DCIS in a benign phyllodes tumour identified in postoperative histology in a 45-year-old is reported. All published literature in PubMed/Medline, Ovid and Cochrane library were reviewed.

Results: A 45-year-old female presented with a smooth, benign-feeling lump. Triple assessment confirmed an 8 cm breast imaging reporting and data system (BiRADS) 3 lesion, which was fibroadenoma with no cytological atypia on core biopsy. Following multidisciplinary meeting (MDM) discussion, she underwent a lumpectomy. Postoperative histology confirmed benign phyllodes with low-grade DCIS, no invasive focus. She chose to have mastectomy and immediate deep inferior epigastric perforator reconstruction. Database search identified 32 cases of DCIS within phyllodes, aged 19 to 80 years old. No higher-level evidence was found. 39% of lesions occurred in malignant phyllodes. The rest occurred in borderline or benign tumours. Tumour size ranged from 2 to 21 cm. Three of the published 32 cases (9.4%) were diagnosed preoperatively as DCIS within a fibroepithelial stroma on core biopsy.

Conclusions: There were no clinical or radiological signs that consistently identified the presence of DCIS within fibroepithelial tumours. We observed in the literature that preoperative pathology identified DCIS in phyllodes tumours that were smaller than 5 cm. This might suggest increased false negative biopsy rate in lesions bigger than 5 cm.

Keywords: Breast cancer; breast surgery; ductal carcinoma in situ (DCIS); fibroepithelial lesion; phyllodes tumour

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-21-ab164
Cite this abstract as: Crone LN, Harris J, Abd Elwahab SM, Butt A, Hill ADK. SOH21AS161. Ductal carcinoma in situ in fibroepithelial breast lesions, can it be diagnosed preoperatively?—Review of literature and case report. Mesentery Peritoneum 2021;5:AB164.

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