Phyllodes Tumor of the Breast: Histopathologic Features, Differential Diagnosis, and Molecular/Genetic Updates

Zhang, Yanhong; Kleer, Celina G.

doi:10.5858/arpa.2016-0042-ra

Cited by 202 publications

(260 citation statements)

References 53 publications

(62 reference statements)

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“…Studies have shown that p53, Ki67, CD117, EGFR, p16 and VEGF are associated with histological grades. 29 The results indicate that the lowest expression is correlated with benign phyllodes tumours, meanwhile the highest is in malignant type. In fact, they may be valuable in differentiating fibroadenomas from phyllodes tumors and even to separate between grades of phyllodes tumours.…”

Section: Diagnosismentioning

confidence: 97%

Approaches to phyllodes tumour of the breast: a review article

et al. 2017

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Phyllodes tumours are rare entities of fibroepithelial diseases. The exact pathogenesis and their relationship with fibroadenomas are oblivious. Women aged between 35 to 55 years are commonly affected, even younger in Asian population. Triple assessment should be applied as a guide to management in any breast pathology. Clinical appearances are typically diagnostic for phyllodes tumours. Even though sometimes inconclusive, mammography and ultrasonography are the main imaging modalities. Although the role of cytology is debatable, presence of both epithelial and stromal elements supports the diagnosis especially in malignant type. Core biopsy is rather favored in view of higher accuracy for the diagnosis. Accurate preoperative assessment and histologic diagnosis allow correct surgical intervention and subsequent avoidance of reoperation. Surgical management can be either wide excision with more than 1 cm margins or mastectomy without axillary surgery. Local recurrence has been associated with inadequate excision of the pseudopod. Adjuvant radiotherapy is recommended for positive surgical margin and for local control of borderline and malignant phyllodes tumors. The role of chemotherapy and endocrine therapy has not been fully studied.

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Section: Diagnosismentioning

confidence: 97%

Approaches to phyllodes tumour of the breast: a review article

et al. 2017

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“…As patients with metastatic PTs may not respond well to standard chemotherapy, death often ensues [4]. As many as 15 studies summarized in Table 1 describe a 100.0% mortality rate amongst patients with metastatic PTs.…”

Section: Prognosis Of Patients With Metastasis In Ptmentioning

confidence: 99%

Distant metastases in phyllodes tumours of the breast: an overview

2017

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Phyllodes tumours (PTs) of the breast are uncommon fibroepithelial neoplasms, comprising 0.3 -1.0% of all primary breast malignancies in Western countries, but accounting for a higher proportion of primary breast tumours in Asian countries. They are graded as benign, borderline or malignant based on the World Health Organisation (WHO) classification, according to a constellation of 5 histologic parameters. While most PTs carry a good prognosis, malignant and occasionally borderline PTs have the potential to metastasize to distant sites. Although events of distant metastasis are few, the prognosis for such patients is dismal, as they are often unresponsive to chemotherapy with high mortality. This review seeks to provide an overview of this rare but important phenomenon of distant metastases in PTs of the breast.

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“…The local recurrence rate is around 20% in benign PT and is up to 25% in borderline PT. In malignant PT, the recurrence rate may as high as 40% and distant metastases may occur in 9% to 27% of cases 4 . The bilateral synchronous or metachronous representation of breast PTs is very rare.…”

Section: Figure 1 Positron Emission Tomography-computed Tomography (mentioning

confidence: 99%

“…This classification is based on histologic features that include stromal hypercellularity, cellular pleomorphism, mitosis (per 10 HPF), tumor margin and stromal pattern 1 . Phyllodes tumors are benign in 60% -75% of cases, borderline in 12% -26% and malignant in 10% -15% 4 . A number of reports described bilateral breast PTs which is an uncommon presentation of this relatively rare tumor [5][6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Bilateral Phyllodes Tumor of the Breast; a Case Report of Benign Tumor on One Side and Malignant Tumor on the Contralateral Side

Azim

Abdel‐Rahman

Abdel-Malek

2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Introduction: Phyllodes tumors (PTs) of the breast are rare fibroepithelial neoplasms which may be benign, borderline or malignant. Malignant PTs tends to recur more frequently and has the potential to metastasize. Bilateral PT is a rare presentation of the disease. Case presentation: We report a case of 34 years old female patient with bilateral breast PT, malignant on one side and benign on the contralateral one. First, she underwent lumpectomy for right breast benign PT which recurred six month later and underwent right mastectomy. One year later, she underwent excision of left breast borderline PT which recurred six months later. The recurrence was in the form of malignant PT for which she underwent mastectomy. Almost one year later, she developed right chest wall recurrence and was found to have bone, brain and lung metastases. She received one cycle of ifosfamide plus doxorubicin with no noticeable response after which she deteriorated rapidly and died few weeks later. Discussion: Bilateral breast PT is very rare and its management represents a challenge in view of limited evidence.

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Phyllodes Tumor of the Breast: Histopathologic Features, Differential Diagnosis, and Molecular/Genetic Updates

Cited by 202 publications

References 53 publications

Approaches to phyllodes tumour of the breast: a review article

Approaches to phyllodes tumour of the breast: a review article

Distant metastases in phyllodes tumours of the breast: an overview

Bilateral Phyllodes Tumor of the Breast; a Case Report of Benign Tumor on One Side and Malignant Tumor on the Contralateral Side

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