Analysis of the progression of fibroepithelial tumours of the breast by PCR-based clonality assay

Arno Kuijper, Horst Buerger, Ronald Simon, Karl Ludwig Schaefer, Anita Croonen, Werner Boecker, Elsken Der Van Wall, Paul J. Van Diest

Research output: Contribution to journalArticlepeer-review

78 Scopus citations


Fibroadenoma and phyllodes tumour of the breast are both fibroepithelial tumours. Although progression to epithelial malignancy has been described, the behaviour of most fibroadenomas is benign. Phyllodes tumours, on the other hand, can display locally destructive growth and can even metastasize. A relationship between the two tumours has been suggested in the literature. This study investigated the clonality of both the stroma and the epithelium of these fibroepithelial tumours and attempted to construct a model in which fibroadenoma can progress in both an epithelial and a stromal direction. Fibroadenomas (n = 25) and phyllodes tumours (n = 12) were selected for analysis. Tissue was microdissected and analysed for clonality using a polymerase chain reaction (PCR)-based assay targeted at an X-linked polymorphic marker, the human androgen receptor gene (HUMARA). Nineteen fibroadenomas and nine phyllodes tumours could be analysed. Normal-appearing epithelium, hyperplastic epithelium, and stroma removed from fibroadenomas were polyclonal. As expected, carcinoma in situ (CIS) removed from four fibroadenomas was monoclonal. Three areas of apparent stromal expansion within fibroadenoma were monoclonal, suggesting stromal progression. Mostly, the stroma of phyllodes tumours was monoclonal and the epithelium polyclonal. In two cases, however, the epithelium seemed to be monoclonal, whereas in three other cases the stromal component was polyclonal. These findings indicate that fibroadenoma can progress in an epithelial direction to CIS and in a stromal direction to phyllodes tumour.

Original languageEnglish (US)
Pages (from-to)575-581
Number of pages7
JournalJournal of Pathology
Issue number5
StatePublished - 2002
Externally publishedYes


  • Breast
  • Clonality
  • Fibroadenoma
  • Phyllodes tumour

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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