{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T10:55:52Z","timestamp":1776682552630,"version":"3.51.2"},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T00:00:00Z","timestamp":1579737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T00:00:00Z","timestamp":1579737600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T00:00:00Z","timestamp":1579737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>When needle core biopsies (NCBs) of the breast reveal fibroepithelial lesions (FELs), excision is often performed to rule out a phyllodes tumor (PT), despite low malignancy rates. Consequently, the natural history of observed FELs is not well described. We analyzed the malignancy risk in excised FELs and the natural history of FELs undergoing active surveillance (AS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively studied the pathology and imaging records of 215 patients with FELs (<jats:italic>n<\/jats:italic>\u2009=\u2009252) diagnosed on NCB. Incidence of growth was determined by Kaplan\u2013Meier method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 252 FELs, 80% were immediately excised and 20% underwent AS. Of the excised FELs, 198 (98%) were benign: fibroadenoma (FA) or benign breast tissue in 137 (68%), benign PT in 59 (29%), or LCIS in 2 (1%). Borderline PT or malignant lesions were found in 4 (2%). On ultrasound, malignant and borderline PTs were larger than benign lesions [median 3.9 vs 1.3\u00a0cm, <jats:italic>p<\/jats:italic>\u2009=\u20090.006]. Fifty FELs underwent AS, with a median follow\u2010up of 17 (range 2\u201379) months. The majority remained stable or decreased in size: at 2 years, only 35% increased in volume by\u2009\u2265\u200950%. Of those tumors undergoing AS that were later excised (<jats:italic>n<\/jats:italic>\u2009=\u20094), all were benign.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Almost all FELs (98%) were benign on surgical excision, and the majority undergoing AS remained stable, with benign pathology if later excised. Most FELs on NCB can be safely followed with US, with surgery reserved for patients with FELs that are large, symptomatic, or growing. This could spare most women with FELs unnecessary surgery.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05385-6","type":"journal-article","created":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T17:04:16Z","timestamp":1579799056000},"page":"1552-1558","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Fibroepithelial Lesions (FELs) of the Breast: Is Routine Excision Always Necessary?"],"prefix":"10.1002","volume":"44","author":[{"given":"Jessica","family":"Limberg","sequence":"first","affiliation":[{"name":"Department of Surgery, Weill Cornell Medical College New York\u2010Presbyterian Hospital 420 East 70th St, Room 251 10021 New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Barker","sequence":"additional","affiliation":[{"name":"Department of Surgery, Weill Cornell Medical College New York\u2010Presbyterian Hospital 420 East 70th St, Room 251 10021 New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed","family":"Hoda","sequence":"additional","affiliation":[{"name":"Department of Pathology, Weill Cornell Medical College New York\u2010Presbyterian Hospital New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rache","family":"Simmons","sequence":"additional","affiliation":[{"name":"Department of Surgery, Weill Cornell Medical College New York\u2010Presbyterian Hospital 420 East 70th St, Room 251 10021 New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aya","family":"Michaels","sequence":"additional","affiliation":[{"name":"Department of Radiology, Weill Cornell Medical College New York\u2010Presbyterian Hospital New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Marti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Weill Cornell Medical College New York\u2010Presbyterian Hospital 420 East 70th St, Room 251 10021 New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,23]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Official Statements | ASBrS.https:\/\/www.breastsurgeons.org\/resources\/statements. Accessed 24 May 2019"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath\u20102017\u2010204977"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2015.09.001"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1066896914548763"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.73"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u20104741.2010.01013.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.5152\/dir.2013.13133"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2012.03.059"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102559.2010.03607.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPZUZ96RESGPUP"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.12706"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2016.12.017"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2016.10.109"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.18554"},{"key":"e_1_2_7_16_1","unstructured":"Consensus Guideline on Concordance Assessment of Image\u2010Guided Breast Biopsies and Management of Borderline or High\u2010Risk Lesions|ASBrS.https:\/\/www.breastsurgeons.org\/docs\/statements\/Consensus\u2010Guideline\u2010on\u2010Concordance\u2010Assessment\u2010of\u2010Image\u2010Guided\u2010Breast\u2010Biopsies.pdf. Accessed 24 May 2019"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-020-05385-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-020-05385-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-020-05385-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-020-05385-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,24]],"date-time":"2023-12-24T04:17:50Z","timestamp":1703391470000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-020-05385-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,23]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1007\/s00268-020-05385-6"],"URL":"https:\/\/doi.org\/10.1007\/s00268-020-05385-6","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,23]]},"assertion":[{"value":"23 January 2020","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"No conflicts of interest reported by any contributing author.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This retrospective review was approved by our Institutional Review Board for Human Participant Research (IRB). Individual patient consent was not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}