Clinicopathologic Characteristics and Patient Outcomes of Phyllodes Tumors: A Single Institution Experience

Abstract

Phyllodes tumors (PT) are rare fibroepithelial neoplasms that are classified as benign, borderline, or malignant. Patients with PT diagnosed between 2009 and 2019 were identified from a prospectively maintained single institutional database. 76 patients with PT were included; 47 (61.8%) were benign, 9 (11.8%) were borderline, and 20 (26.3%) were malignant. The mean age at diagnosis was 52. Surgical treatment of benign PT included excisional biopsy in 31 (66.0%) patients, segmental mastectomy in 15 (31.9%), and mastectomy in 1 (2.1%). Among patients with borderline PT, operative management was excisional biopsy in 4 (44.4%) and segmental mastectomy in 5 (55.6%). Of those with malignant PT, 7 (35.0%) were treated with excisional biopsy alone, 9 (45.0%) had lumpectomy (segmental mastectomy), and 4 (20.0%) underwent mastectomy. Malignant PT had a higher rate of necrosis compared to borderline or benign PT (25.0% vs 0% vs 4.3%, P = .016). Four patients had recurrent PT. Final positive margins were associated with recurrence ( P = .044). The median overall follow-up time was 86.3 months (range 1.5-1414.1 months), and no deaths occurred among patients with malignant PT. Overall, recurrence rates of PT are low but may be increased by presence of positive margins.

Role and Involvement of TENM4 and miR-708 in Breast Cancer Development and Therapy

“…As a step forward for a more faithful representation of the human breast cancer in toto, innovative lines of research include looking towards the development of three-dimensional (3D) models called “organoids”. Many protocols have been developed and improved for the generation of breast organoids, with the inclusion of fresh tissue in different types of matrices and media components [ 89 ]. Breast organoids can be derived from normal breast tissue and are being genetically engineered with different technologies, including the CRISPR/Cas9 [ 90 ], allowing for the exploration of the relevance of tumor-suppressors or oncogenes, including TENM4, in breast cancer initiation and progression.…”

Giant Phyllodes Tumor in an 82-Year-Old Female Initially Diagnosed a Fibroadenoma: A Case Report

“…Phyllodes tumors are a rare type of fibroepithelial neoplasms of the breast typically occurring in women of ages 35-55 years, and accounting for approximately 0.3-0.9% of all primary breast neoplasms [1][2][3][4][5][6][7]. Phyllodes tumors and fibroadenomas are both included in the category of biphasic fibroepithelial lesions of the breast; fibroadenomas are far more common in clinical practice and constitute the majority of benign breast masses in younger women [2,[7][8][9].…”

“…Phyllodes tumors and fibroadenomas are both included in the category of biphasic fibroepithelial lesions of the breast; fibroadenomas are far more common in clinical practice and constitute the majority of benign breast masses in younger women [2,[7][8][9]. Phyllodes tumors can be categorized histologically as either benign, borderline, or malignant based on the degree of stromal proliferation [6,7,10]. Benign phyllodes tumors have an increased degree of stromal cellularity with mild to moderate cellular atypia, borderline ones demonstrate a greater degree of stromal cellularity and cellular atypia, and malignant ones demonstrate marked stromal cellularity and atypia [6,7,10].…”

“…Phyllodes tumors can be categorized histologically as either benign, borderline, or malignant based on the degree of stromal proliferation [6,7,10]. Benign phyllodes tumors have an increased degree of stromal cellularity with mild to moderate cellular atypia, borderline ones demonstrate a greater degree of stromal cellularity and cellular atypia, and malignant ones demonstrate marked stromal cellularity and atypia [6,7,10]. The majority of phyllodes tumors are classified as benign variants [6,7,10].…”

“…Benign phyllodes tumors have an increased degree of stromal cellularity with mild to moderate cellular atypia, borderline ones demonstrate a greater degree of stromal cellularity and cellular atypia, and malignant ones demonstrate marked stromal cellularity and atypia [6,7,10]. The majority of phyllodes tumors are classified as benign variants [6,7,10]. The stromal architecture is described histologically as displaying an intracanalicular growth pattern with leaf-like stromal processes that can be demonstrated on core biopsy of the lesion [2].…”