An approach to the diagnosis of spindle cell lesions of the breast
- 4 December 2015
- journal article
- review article
- Published by Wiley in Histopathology
- Vol. 68 (1), 33-44
- https://doi.org/10.1111/his.12865
Abstract
Although most breast spindle cell lesions (BSCLs) are rare, they constitute a wide spectrum of diseases, ranging from reactive processes to aggressive malignant tumours. Despite their varied histogenesis and behaviour, some lesions show an overlap of morphological features, making accurate diagnosis a challenging task, particularly in needle core biopsies. Clinical history and immunohistochemistry can help in making a correct diagnosis in morphologically challenging cases. To make an accurate diagnosis, it is important to maintain a wide differential diagnosis and be familiar with the diverse morphological appearances of these different entities. BSCLs can generally be classified into bland‐looking and malignant‐looking categories. In the former, the commonest diagnosis is scarring. However, it is important to distinguish low‐grade spindle cell metaplastic breast carcinoma from other benign entities, as the management is clearly different. In the malignant category, it is important to differentiate metaplastic carcinoma from other malignant primary and metastatic malignant spindle cell tumours of the breast, such as malignant phyllodes tumour, angiosarcoma, and melanoma. This review focuses on the classification and histological and molecular diagnosis of various BSCLs, with an emphasis on the diagnostic approach, including in core biopsies.Keywords
This publication has 60 references indexed in Scilit:
- Myofibroblastoma of the breast: Case report and literature reviewInternational Journal of Surgery Case Reports, 2011
- Diagnostic utility of snail in metaplastic breast carcinomaDiagnostic Pathology, 2010
- β-catenin/Wnt signalling pathway in fibromatosis, metaplastic carcinomas and phyllodes tumours of the breastLaboratory Investigation, 2010
- Phenotypic and molecular characterization of the claudin-low intrinsic subtype of breast cancerBreast Cancer Research, 2010
- Core epithelial-to-mesenchymal transition interactome gene-expression signature is associated with claudin-low and metaplastic breast cancer subtypesProceedings of the National Academy of Sciences of the United States of America, 2010
- Breast Carcinoma With Chondroid Differentiation: A Clinicopathologic Study of 21 Triple Negative (ER−, PR−, Her2/neu−) CasesInternational Journal of Surgical Pathology, 2009
- Metaplastic breast carcinomas are basal-like breast cancers: a genomic profiling analysisBreast Cancer Research and Treatment, 2008
- Molecular analysis of metaplastic breast carcinoma: high EGFR copy number via aneusomyMolecular Cancer Therapeutics, 2008
- Spindle cell lesions of the breast—the pathologic differential diagnosisBreast Cancer Research and Treatment, 2007
- Primary breast sarcoma: clinicopathologic series from the Mayo Clinic and review of the literatureBritish Journal of Cancer, 2004