Genetic differences between benign phyllodes tumors and fibroadenomas revealed through targeted next generation sequencing

Mod Pathol. 2021 Jul;34(7):1320-1332. doi: 10.1038/s41379-021-00787-w. Epub 2021 Mar 16.

Abstract

Breast fibroepithelial lesions are biphasic tumors which comprise the common benign fibroadenomas (FAs) and the rarer phyllodes tumors (PTs). This study analyzed 262 (42%) conventional FAs, 45 (7%) cellular FAs, and 321 (51%) benign PTs contributed by the International Fibroepithelial Consortium, using a previously curated 16 gene panel. Benign PTs were found to possess a higher number of mutations, and higher rates of cancer driver gene alterations than both groups of FAs, in particular MED12, TERT promoter, RARA, FLNA, SETD2, RB1, and EGFR. Cases with MED12 mutations were also more likely to have TERT promoter, RARA, SETD2, and EGFR. There were no significant differences detected between conventional FAs and cellular FAs, except for PIK3CA and MAP3K1. TERT promoter alterations were most optimal in discriminating between FAs and benign PTs. Our study affirms the role of sequencing and key mutations that may assist in refining diagnoses of these lesions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / pathology
  • DNA Mutational Analysis
  • Diagnosis, Differential
  • Female
  • Fibroadenoma / diagnosis
  • Fibroadenoma / genetics*
  • Fibroadenoma / pathology
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Mutation
  • Phyllodes Tumor / diagnosis
  • Phyllodes Tumor / genetics*
  • Phyllodes Tumor / pathology