Primary treatment of cystosarcoma phyllodes of the breast

Chaney, Arthur W.; Pollack, Alan; McNeese, Marsha D.; Zagars, Gunar K.; Pisters, Peter W.T.; Pollock, Raphael E.; Hunt, Kelly K.

doi:10.1002/1097-0142(20001001)89:7<1502::aid-cncr13>3.0.co;2-p

Cited by 350 publications

(425 citation statements)

References 21 publications

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“…Axillary lymph node involvements are described in fewer than 5% of all patients with phyllodes tumors (Belkacemi et al, 2008;SuzukiUematsu et al, 2010), otherwise, malignant PTs are bloodvessle-borne metastasis, so routine axillary lymph node dissection seems unnecessary, unless there is certain metastasies or clinical palpable lymph node. Although the histologic type is an established independent prognostic factor for survival (Chaney et al, 2000), the prognostic value of other parameters remains uncertain. Moreover, there are no definite predisposing factors and the etiology of phyllodes tumor is not clearly known.…”

Section: Introductionsupporting

confidence: 64%

Comparison of Clinical Characteristics Between Benign Borderline and Malignant Phyllodes Tumors of the Breast

Wang

Wang²,

Wang³

2015

Asian Pacific Journal of Cancer Prevention

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Section: Introductionsupporting

confidence: 64%

Comparison of Clinical Characteristics Between Benign Borderline and Malignant Phyllodes Tumors of the Breast

Wang

Wang²,

Wang³

2015

Asian Pacific Journal of Cancer Prevention

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“…1 Benign and borderline phyllodes tumors carry the potential for local recurrence, with the risk of metastasis primarily limited to malignant phyllodes tumors. [2][3][4][5] Precise classification of these benign and low-grade fibroepithelial neoplasms can be difficult in daily practice. The morphologic features of fibroadenomas with pronounced intracanalicular growth pattern and of benign phyllodes tumors overlap, leading to high interobserver variability in classification of these lesions, even among breast pathology experts.…”

mentioning

confidence: 99%

Benign and low-grade fibroepithelial neoplasms of the breast have low recurrence rate after positive surgical margins

2016

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Breast phyllodes tumors are uncommon fibroepithelial neoplasms with a range of histologic features. Surgical excision is the primary management, but the need for excision to negative margins in benign and borderline phyllodes tumors is unclear. Here, we review the surgical management patterns and outcomes of 90 patients with benign and low-grade fibroepithelial lesions of the breast treated at our institution, including 19 borderline phyllodes tumors, 52 benign phyllodes tumors, and 19 representative neoplasms with overlapping features of fibroadenoma and benign phyllodes tumors, which were classified as 'fibroadenomas with phyllodal features'. In total, 52 (58%) had positive surgical margins on first excision, and of these 17 (33%) underwent re-excision to achieve negative margins. Residual tumor was identified in three (18%) re-excisions. Patients with fibroadenoma with phyllodal features were more likely to have a positive surgical margin than with benign phyllodes tumors or borderline phyllodes tumors (89 vs 49%, P = 0.0015), and were less likely to undergo re-excision for positive margins (12 vs 43%, P = 0.031). In total, there were three recurrences (3%), with one per fibroadenoma with phyllodal features, benign phyllodes tumor, and borderline phyllodes tumor. There was no statistically significant difference in recurrence rates between patients with positive or negative margins, or between patients with positive margin with or without re-excision. The extent of the positive margin did not predict recurrence. In conclusion, the recurrence rate of benign and low-grade fibroepithelial lesions is low and not associated with the original margin status. Patients with fibroadenomas with phyllodal features, benign phyllodes tumors, or selected borderline phyllodes tumors and positive margins on initial excision may be managed conservatively, with close follow-up and timely re-excision of any potential recurrence.

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“…Our patient, in addition to 37% of the female population studied at the Memorial Sloan Kettering Cancer Center [14], reported a history of fibroadenoma preceding the diagnosis of the phyllodes tumour. Another hypothesis that could explain the mechanism that initiates the development of PT seems to be a loss of balance in the interaction between stroma and the epithelium, due to an uncontrollable growth of the mesenchymal component, which becomes progressively independent from the ductal epithelium, assuming malignant features [15,16].…”

Section: Discussionmentioning

confidence: 99%

“…Usually, these tumours rarely present lymph node involvement. Recommended treatment consists of surgical excision of the lesion, with particular attention to obtaining disease-free margins [16]. In our case, total mastectomy was preferred because of the local extension of the tumour and the apparent involvement of the skin.…”

Section: Discussionmentioning

confidence: 99%

Angiosarcomatoid Dermo-Hypodermic Lung and Cardiac Metastases from Malignant Breast Phyllodes Tumour

Bella¹,

Ferrara²

2016

J Med Diagn Meth

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Primary treatment of cystosarcoma phyllodes of the breast

Cited by 350 publications

References 21 publications

Comparison of Clinical Characteristics Between Benign Borderline and Malignant Phyllodes Tumors of the Breast

Comparison of Clinical Characteristics Between Benign Borderline and Malignant Phyllodes Tumors of the Breast

Benign and low-grade fibroepithelial neoplasms of the breast have low recurrence rate after positive surgical margins

Angiosarcomatoid Dermo-Hypodermic Lung and Cardiac Metastases from Malignant Breast Phyllodes Tumour

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