Skip to main content
SpringerLink
Log in

Mesenchymal Tumors of the Breast

  • Chapter
  • First Online:
Practical Atlas of Breast Pathology

  • 2542 Accesses

Abstract

Mesenchymal breast lesions include a variety of benign and malignant neoplasms, as well as reactive and tumor-like lesions made up of mesenchymal cells. They frequently pose diagnostic challenges to surgical pathologists. This chapter provides a diagnostic approach to benign and malignant mesenchymal lesions of the breast, with emphasis on those that enter the differential diagnosis with spindle cell metaplastic carcinoma and malignant phyllodes tumor. Close clinicopathological correlation is recommended in the evaluation of both spindle cell/fibrous and vascular lesions of the breast.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Cheah AL, Billings SD, Rowe JJ. Mesenchymal tumours of the breast and their mimics: a review with approach to diagnosis. Pathology. 2016;48:406–24.

    Article  PubMed  Google Scholar 

  2. Torous VF, Schnitt SJ, Collins LC. Benign breast lesions that mimic malignancy. Pathology. 2017;49:181–96.

    Article  PubMed  Google Scholar 

  3. Schnitt SJ, Collins LC. Reactive, inflammatory, and nonproliferative lesions. In: Schnitt SJ, Collins LC, editors. Biopsy interpretation of the breast. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. p. 25–57.

    Google Scholar 

  4. Lim SZ, Ong KW, Tan BK, Selvarajan S, Tan PH. Sarcoma of the breast: an update on a rare entity. J Clin Pathol. 2016;69:373–81.

    Article  PubMed  Google Scholar 

  5. Adem C, Reynolds C, Ingle JN, Nascimento AG. Primary breast sarcoma: clinicopathologic series from the Mayo Clinic and review of the literature. Br J Cancer. 2004;91:237–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Voutsadakis IA, Zaman K, Leyvraz S. Breast sarcomas: current and future perspectives. Breast. 2011;20:199–204.

    Article  PubMed  Google Scholar 

  7. Pandey M, Mathew A, Abraham EK, Rajan B. Primary sarcoma of the breast. J Surg Oncol. 2004;87:121–5.

    Article  PubMed  Google Scholar 

  8. Schnitt SJ, Collins LC. Spindle cell lesions. In: Schnitt SJ, Collins LC, editors. Biopsy interpretation of the breast. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. p. 363–86.

    Google Scholar 

  9. Rakha EA, Aleskandarany MA, Lee AH, Ellis IO. An approach to the diagnosis of spindle cell lesions of the breast. Histopathology. 2016;68:33–44.

    Article  PubMed  Google Scholar 

  10. Reis-Filho JS, Lakhani SR, Gobbi H, Sneige N. Metaplastic carcinoma. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 48–52.

    Google Scholar 

  11. Tan BY, Acs G, Apple SK, Badve S, Bleiweiss IJ, Brogi E, et al. Phyllodes tumours of the breast: a consensus review. Histopathology. 2016;68:5–21.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Thornton K. Sarcomas of the breast with a spotlight on angiosarcoma and cystosarcoma phyllodes. Surg Oncol Clin N Am. 2016;25:713–20.

    Article  PubMed  Google Scholar 

  13. Gobbi H, Tse G, Page DL, Olson SJ, Jensen RA, Simpson JF. Reactive spindle cell nodules of the breast after core biopsy or fine-needle aspiration. Am J Clin Pathol. 2000;113:288–94.

    Article  CAS  PubMed  Google Scholar 

  14. Powell CM, Cranor ML, Rosen PP. Pseudoangiomatous stromal hyperplasia (PASH). A mammary stromal tumor with myofibroblastic differentiation. Am J Surg Pathol. 1995;19:270–7.

    Article  CAS  PubMed  Google Scholar 

  15. Michal M, Badve S, Shin SJ. Pseudoangiomatous stromal hyperplasia. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 129–30.

    Google Scholar 

  16. Gobbi H, Fletcher C. Nodular fasciitis. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 126.

    Google Scholar 

  17. Montgomery EA, Meis JM. Nodular fasciitis. Its morphologic spectrum and immunohistochemical profile. Am J Surg Pathol. 1991;15:942–8.

    Article  CAS  PubMed  Google Scholar 

  18. Gobbi H, Simpson JF, Borowsky A, Jensen RA, Page DL. Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence. Cancer. 1999;85:2170–82.

    Article  CAS  PubMed  Google Scholar 

  19. Fletcher CDM. Inflammatory myofibroblastic tumour. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 133.

    Google Scholar 

  20. Gobbi H, Atkinson JB, Kardos TF, Simpson JF, Page DL. Inflammatory myofibroblastic tumor of the breast: report of a case with giant vacuolated cells. Breast. 1999;8:135–8.

    Article  CAS  PubMed  Google Scholar 

  21. Wargotz ES, Weiss SW, Norris HJ. Myofibroblastoma of the breast. Sixteen cases of a distinctive benign mesenchymal tumor. Am J Surg Pathol. 1987;11:493–502.

    Article  CAS  PubMed  Google Scholar 

  22. Fukunaga M, Ushigome S. Myofibroblastoma of the breast with diverse differentiations. Arch Pathol Lab Med. 1997;121:599–603.

    PubMed  CAS  Google Scholar 

  23. Magro G, Fletcher CDM, Eusebi V. Myofibroblastoma. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 130–1.

    Google Scholar 

  24. Rosen PP, Ernsberger D. Mammary fibromatosis. A benign spindle-cell tumor with significant risk for local recurrence. Cancer. 1989;63:1363–9.

    Article  CAS  PubMed  Google Scholar 

  25. Lee A, Gobbi H. Desmoid-type fibromatosis. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 131–2.

    Google Scholar 

  26. Abraham SC, Reynolds C, Lee JH, Montgomery EA, Baisden BL, Krasinskas AM, Wu TT. Fibromatosis of the breast and mutations involving the APC/beta-catenin pathway. Hum Pathol. 2002;33:39–46.

    Article  CAS  PubMed  Google Scholar 

  27. Gobbi H, Tan PH. Lipoma. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 123–4.

    Google Scholar 

  28. Schnitt SJ, Collins LC. Other mesenchymal lesions. In: Schnitt SJ, Collins LC, editors. Biopsy interpretation of the breast. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. p. 408–18.

    Google Scholar 

  29. Tan PH, Tse G, Lee A, Simpson JF, Hanby AM. Fibroepithelial tumours. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 142–7.

    Google Scholar 

  30. Daya D, Trus T, D'Souza TJ, Minuk T, Yemen B. Hamartoma of the breast, an underrecognized breast lesion. A clinicopathologic and radiographic study of 25 cases. Am J Clin Pathol. 1995;103:685–9.

    Article  CAS  PubMed  Google Scholar 

  31. Tse GM, Law BK, Ma TK, Chan AB, Pang LM, Chu WC, Cheung HS. Hamartoma of the breast: a clinicopathological review. J Clin Pathol. 2002;55:951–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Fox SB, Lee A. Granular cell tumor and benign peripheral nerve-sheath tumours. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 134–5.

    Google Scholar 

  33. Fanburg-Smith JC, Meis-Kindblom JM, Fante R, Kindblom LG. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol. 1998;22:779–94.

    Article  CAS  PubMed  Google Scholar 

  34. Donnell RM, Rosen PP, Lieberman PH, Kaufman RJ, Kay S, Braun DW Jr, Kinne DW. Angiosarcoma and other vascular tumors of the breast. Am J Surg Pathol. 1981;5:629–42.

    Article  CAS  PubMed  Google Scholar 

  35. Ginter PS, McIntire PJ, Shin SJ. Vascular tumours of the breast: a comprehensive review with focus on diagnostic challenges encountered in the core biopsy setting. Pathology. 2017;49:197–214.

    Article  PubMed  Google Scholar 

  36. MacGrogan G, Skalova A, Shin SJ. Benign vascular lesions. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 127–8.

    Google Scholar 

  37. Schnitt SJ, Collins LC. Vascular lesions. In: Schnitt SJ, Collins LC, editors. Biopsy interpretation of the breast. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. p. 387–407.

    Google Scholar 

  38. Rosen PP. Vascular tumors of the breast. III. Angiomatosis. Am J Surg Pathol. 1985;9:652–8.

    Article  CAS  PubMed  Google Scholar 

  39. Fineberg S, Rosen PP. Cutaneous angiosarcoma and atypical vascular lesions of the skin and breast after radiation therapy for breast carcinoma. Am J Clin Pathol. 1994;102:757–63.

    Article  CAS  PubMed  Google Scholar 

  40. Fraga-Guedes C, Gobbi H, Mastropasqua MG, Rocha RM, Botteri E, Toesca A, Viale G. Clinicopathological and immunohistochemical study of 30 cases of post-radiation atypical vascular lesion of the breast. Breast Cancer Res Treat. 2014;146:347–54.

    Article  CAS  PubMed  Google Scholar 

  41. Fraga-Guedes C, André S, Mastropasqua MG, Botteri E, Toesca A, Rocha RM, et al. Angiosarcoma and atypical vascular lesions of the breast: diagnostic and prognostic role of MYC gene amplification and protein expression. Breast Cancer Res Treat. 2015;151:131–40.

    Article  CAS  PubMed  Google Scholar 

  42. Fletcher CDM, MacGrogan G, Fox SB. Angiosarcoma. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 135–6.

    Google Scholar 

  43. Fraga-Guedes C, Gobbi H, Mastropasqua MG, Botteri E, Luini A, Viale G. Primary and secondary angiosarcomas of the breast: a single institution experience. Breast Cancer Res Treat. 2012;132:1081–8.

    Article  CAS  PubMed  Google Scholar 

  44. Scow JS, Reynolds CA, Degnim AC, Petersen IA, Jakub JW, Boughey JC. Primary and secondary angiosarcoma of the breast: the Mayo Clinic experience. J Surg Oncol. 2010;101:401–7.

    PubMed  Google Scholar 

  45. Fletcher CDM, Eusebi V. Liposarcoma. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 137.

    Google Scholar 

  46. Fletcher CDM, Eusebi V. Osteosarcoma. In: Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, editors. WHO classification of tumours of the breast. 4th ed. Lyon: IARC Press; 2012. p. 138–9.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Institute of Health Sciences, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil

    Helenice Gobbi MD, PhD

  2. Department of Anatomic Pathology, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Cristiana Buzelin Nunes PhD

Authors
  1. Helenice Gobbi MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cristiana Buzelin Nunes PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Pathology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

    Simona Stolnicu

  2. Department of Pathology, Hospital de Oncologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico

    Isabel Alvarado-Cabrero

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gobbi, H., Nunes, C.B. (2018). Mesenchymal Tumors of the Breast. In: Stolnicu, S., Alvarado-Cabrero, I. (eds) Practical Atlas of Breast Pathology . Springer, Cham. https://doi.org/10.1007/978-3-319-93257-6_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-93257-6_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-93256-9

  • Online ISBN: 978-3-319-93257-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation