DNA Content and Proliferative Activity of Cystosarcoma Phyllodes of the Breast: Potential Prognostic Significance

Abstract

Predicting the biologic behavior of cystosarcoma phyllodes of the breast by histopathologic examination has been difficult. Flow cytometric DNA and cell cycle analysis was performed for 30 patients with cystosarcoma phyllodes of the breast to determine its potential prognostic utility. Traditional histopathologic parameters and the patients' clinical outcome with a minimum follow-up period of at least five years were also analyzed. Of all the variables examined, DNA ploidy, proliferative index, number of mitoses, and tumor margin were significantly associated with an adverse clinical course. Multivariate regression analysis of the authors' data showed that DNA content was a significant predictor of the patients' clinical outcome. The authors conclude that the DNA ploidy study is a useful, objective adjunct to the clinicopathologic assessment of cystosarcoma phyllodes of the breast.

Primary treatment of cystosarcoma phyllodes of the breast

“…19,21 These included stromal cellularity, nuclear pleomorphism, the number of mitoses per ten highpower fields, the presence of necrosis, the tumor margin, and the presence of stromal overgrowth. Based on these factors, patients were divided into 3 histologic categories: benign (n ϭ 59 patients; 58%), indeterminate (n ϭ 12 patients; 12%), and malignant (n ϭ 30 patients; 30%).…”

Phyllodes tumor of the breast: an update

“…Within the benign group, the expression of MIB1 is related to the stromal cellularity, with highly cellular lesions showing higher MIB1 expression [29]. The utility of Ki67 in predicting outcome is variable, with some studies suggesting MIB1 to be useful in predicting outcome [24,30,31], and others suggesting that MIB1 may also be associated with likelihood of recurrence [21,23,24].…”

“…In general, benign phyllodes tumor is diploid, with aneuploidy identified in some borderline to malignant phyllodes tumors [30,31], and the S-phase fraction also shows a progressive increase from benign, borderline, to malignant phyllodes [30]. Furthermore, both DNA ploidy [31] and S-phase fraction [30] have been reported as independent prognostic indicators in phyllodes tumor.…”

Malignant Phyllodes Tumor with Pleomorphic Liposarcomatous Stroma Diagnosed by Fine Needle Aspiration Cytology

“…Tumor DNA content (ploidy) and proliferative rate (S phase) correlate with outcome independently of histology. 4,13,17 Recurrent phyllodes tumors are generally histologically similar to the primary neoplasms, though they may be more cellular and show a greater degree of atypia. 6,11 Occasionally malignant transformation occurs in a previously benign tumor.…”