Imaging findings in phyllodes tumors of the breast

Tan, Hongna; Zhang, Shengjian; Liu, Haiquan; Peng, Weijun; Li, Ruimin; Gu, Yajia; Wang, Xiaohong; Mao, Jian; Shen, Xizhong

doi:10.1016/j.ejrad.2011.01.085

Cited by 81 publications

(74 citation statements)

References 24 publications

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“…The sonographic and mammographic findings were parallel to the literature; no specific radiologic feature was identified to differentiate the histologic subtypes of PTs. In addition, FA was the most commonly reported radiologic diagnosis with both US and MG, consistent with previous works (15)(16)(17). In recent years, several studies regarding the potential role of magnetic resonance imaging (MRI) in the diagnosis of PT have been published.…”

Section: Fnac: Fine Needle Aspiration Cytologysupporting

confidence: 68%

Phyllodes Tumor of the Breast: Analysis of 48 Patients

et al. 2016

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Section: Fnac: Fine Needle Aspiration Cytologysupporting

confidence: 68%

Phyllodes Tumor of the Breast: Analysis of 48 Patients

et al. 2016

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“…They appear as hyperdense, large, round/lobular, well-circumscribed lesions on MMG, which is the initial imaging modality of choice (12)(13)(14)(15). It was reported that distinguishing these tumors from fibroadenomas was difficult by MMG, since both display similar findings (16,17).…”

Section: Resultsmentioning

confidence: 99%

“…In a study by Tan et al (12), it has been shown that the relative risk of malignancy is 3.87 fold in tumors >3 cm, and that all tumors >8 cm were detected to be malignant on histopathologic evaluation. In our study, the median tumor size was larger in borderline and malignant tumors as compared to benign lesions.…”

Section: Resultsmentioning

confidence: 99%

How to approach phyllodes tumors of the breast?

Acar

Tarcan

Hacıyanlı

et al. 2015

UCD

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Objective: Phyllodes tumor of the breast is a rare fibroepithelial breast tumor that comprise 0.3-0.9% of primary breast neoplasms. In this study, we aimed to present clinicopathologic symptoms of our patients along with their treatment modality. Material and Methods:Clinicopathologic properties and treatment modality of 20 phyllodes tumor patients who underwent surgery between January 2008 and January 2013 were retrospectively evaluated.Results: Median patient age was 47 years (22-75). Fine-needle aspiration biopsy was applied to 19 patients. Biopsy results were reported as suspicious in four, malignant in three, benign in 11, and as non-diagnostic in one patient. Final histopathology reports revealed two benign, one malignant and one borderline tumor out of the four patients with suspicious findings on fine needle aspiration biopsy; all patients with malignant cytology had malignancy. There were two borderline and nine benign lesions within the benign biopsy group. Sixteen patients underwent segmental mastectomy, four patients underwent mastectomy with/without axillary dissection. The median tumor size was 6 (1-13) cm. Histopathologically, 11 (55%) tumors were benign, 5 (25%) were borderline, and 4 (20%) were malignant. Two of the four patients with malignancy underwent radiotherapy and chemotherapy, and one patient only received chemotherapy as adjuvant treatment.Conclusion: Phyllodes tumors are rare, mix-type breast tumors. Due to high rates of local recurrence and potential for malignancy, preoperative diagnosis and accurate management are important.

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“…19,26,27 However, there are several imaging features that are reported to be more frequently detected Full paper: Phyllodes tumour: radiological presentation, management and follow-up BJR in PTs than FAs. These are lobulations, heterogeneous internal texture, cystic components, horizontal linear clefts, hyperechoic septae, rich vascularization, the absence of microcalcifications and irregular margins.…”

Section: Maxwell Et Almentioning

confidence: 99%

Phyllodes tumours of the breast: radiological presentation, management and follow-up

McCarthy¹,

Kavanagh²,

O'Donoghue³

et al. 2014

The British Journal of Radiology

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Results: 53 patients with 54 lesions were diagnosed as having a PT. The median age was 27.5, 35.0 and 38.5 years for benign, borderline and malignant PT, respectively. Borderline and malignant PTs were larger than benign PTs, with mean sizes of 33 and 42 mm compared with 29 mm. 38% of PTs were labelled by the reporting radiologist as fibroadenomas, including two borderline PTs and one malignant PT. In 24% of cases, the radiologist raised the possibility of PT in the report. 17 patients (40%) developed a new fibroepithelial breast lesion during follow-up of which 4 were recurrent PTs. Conclusion: Despite adequate surgical management, the development of further fibroepithelial lesions in the ipsilateral breast is common. 3-year clinical surveillance, with the addition of 6-monthly ultrasound is advised for females with initial borderline or malignant PT histology. Advances in knowledge:We propose a follow-up protocol with ultrasound based on the grade of the PT diagnosed for 3 years to detect recurrence.Phyllodes tumours (PTs) are rare biphasic fibroepithelial neoplasms accounting for ,1% of all breast lesions. 1 In the literature, they have been described as occurring in females aged 35-55 years, typically 15-20 years older than females with fibroadenomas (FAs) and with a higher incidence in Asian females.2,3 Imaging findings of PT and FA overlap and as such lesions may be misdiagnosed. 4 Histologically, PTs can be identified by their distinctive leaf-like architecture and increased stromal cellularity. 5 Typically, PTs present as a palpable breast lump and were traditionally differentiated from FAs based on their larger size at presentation.6 However, with increased breast awareness and screening programmes, smaller and incidental lesions are being found on imaging. 6 In symptomatic breast clinics, including this institution, "triple assessment" consisting an initial physical examination, followed by radiological imaging (ultrasound and/or mammography) and histological sampling either by fine-needle aspiration cytology (FNAC) or core biopsy is the standard diagnostic pathway for palpable breast lesions. The purpose of triple assessment is to provide a more accurate pre-operative diagnosis to ensure proper surgical planning and avoiding re-excision or tumour recurrence. 7According to the World Health Organization criteria, there are two grading systems for PTs; a two-tiered system or a three-tiered system. 8 Our institution employs the threetiered system, the subgroups being benign, borderline and malignant. Grading is based on semi-quantitative assessment of stromal cellularity, cellular pleomorphism, mitotic activity, margin appearance and stromal distribution. The standard procedure for treatment, no matter what the grade of the PT, is surgical wide local excision, preferably with clear margins of at least 1 cm. However, owing to the fact that most PTs are not fully diagnosed pre-operatively, initial surgery does not always provide adequate margins necessitating frequent post-operative re-excision of the margi...

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Imaging findings in phyllodes tumors of the breast

Cited by 81 publications

References 24 publications

Phyllodes Tumor of the Breast: Analysis of 48 Patients

Phyllodes Tumor of the Breast: Analysis of 48 Patients

How to approach phyllodes tumors of the breast?

Phyllodes tumours of the breast: radiological presentation, management and follow-up

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