Recurrent borderline phyllodes tumor of the breast submitted to mastectomy and immediate reconstruction: Case report

Abstract

Highlights Phyllodes tumors of the breast are rare fibroepithelial neoplasms. They are histologically classified into benign, borderline and malignant variants. Anatomopathological examination is considered the definitive diagnostic method. They have a high rate of local recurrence and the possibility of metastases. Surgery is the definitive treatment and adjuvant therapy is controversial.

Phyllodes Tumor of The Breast: Histopathological and Clinical Results of 13 Cases

“…Cytological atypia was not observed, and the mean mitotic figure number per 10 HPF was 1.8 (1-3). On the histological examination of borderline PT, increased stromal cellularity was noted (Figure -4), and the mean mitotic figure number per 10 HPF was 6.6 (5)(6)(7)(8). Nuclear pleomorphism, prominent nucleoli, cytological atypia, bleeding, and necrosis were observed in malignant PT.…”

“…In our series, in line with the literature, the most commonly affected site was the upper outer quadrant, and all masses were unilateral. It most frequently occurs in the age range of 40-50 years, which is 20 years older than the age at which FA occurs 4,8,12 . In our patient group, the mean age at the diagnosis of the tumor was 42.69 years, and malignant PT tended to be seen at a younger age compared to breast cancer, as in the series of Weng et al 7 .…”

“…On USG and MM, large, round, lobulated, well-circumscribed masses with a higher density than adjacent tissue are usually visualized. Cystic areas, heterogeneous content without microcalcification, and acoustic enhancement suggest PT rather than FA, especially when associated with rapid growth and large volume 2,8 . The American College of Radiology (ACR) BI-RADS lexicon classification is a standard reporting guideline widely used for the assessment and classification of breast lesions 13 .…”

“…The cystic component, heterogeneous content without microcalcification, and posterior acoustic enhancement suggest PT rather than FA, especially when associated with rapid growth and large volume 3,4,7 . Visualization of solid components with greater concentration in hemorrhagic cystic cavities on magnetic resonance imaging (MRI) suggests PT 2,8 .…”

Giant Borderline Phyllodes Tumor With Malignant Presentation: A Case Report

“…Unlike the well-studied genetic BRCA1 and BRCA2 mutations in breast cancer, there is a lack of scientific literature linking genetic variations to the growth of PT [12]. There have been studies associating mutations in PT53 gene to malignant PT [12,13]. Our patient was not tested for the PT53 mutation; however, histological staining for calponin, E-cadherin, and Ki-67 was performed to rule out other breast carcinomas, which all returned negative.…”