Distinguishing phyllodes from fibroadenoma by immunohistochemical and swept source-optical coherence tomography studies

Abstract

In pathology, phyllodes and fibroadenoma of breast are two well-known tumors with differential malignant potentialities and aetio-pathology. But diagnostic ambiguity prevails, particularly in the condition of stromal hyper-cellularity. To address such classification problem, current study evaluated fresh breast tumor biopsies in respect to expression of some candidate genes by immunohistochemistry (IHC) and structurally by swept source-optical coherence tomography (SS-OCT). The IHC assessed the expression of p63 and α-SMA in myoepithelial cells (MECs) and collagen I and III in stroma. Through skin SS-OCT, the cross-sectional structural features were noted non-invasively. In phyllodes, expressions of P63 and α-SMA were less in comparison to fibroadenoma and their normal counterpart whereas it was just reverse for collagen I and III. The OCT images demonstrated differential optical features of the biopsies in terms of presence of foaminess in phyllodes in contrast to compactness of fibroadenoma. Thus, the current study identified differential structural and molecular signatures in these tumors, to address the diagnostic ambiguities.