Phyllodes Tumor of Breast: A Review Article

Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Ultar Pradesh 221005, India.
ISRN surgery 03/2013; 2013(3):361469. DOI: 10.1155/2013/361469
Source: PubMed


Introduction. Phyllodes tumours are rare fibroepithelial lesions. Accurate preoperative pathological diagnosis allows correct surgical planning and avoidance of reoperation. Treatment can be either wide local excision or mastectomy to achieve histologically clear margins. Discussion. The exact aetiology of phyllodes tumour and its relationship with fibroadenoma are unclear. Women aged between 35 and 55 years are commonly involved. The median tumour size is 4 cm but can grow even larger having dilated veins and a blue discoloration over skin. Palpable axillary lymphadenopathy can be identified in up to 10-15% of patients but <1% had pathological positive nodes. Mammography and ultrasonography are main imaging modalities. Cytologically the presence of both epithelial and stromal elements supports the diagnosis. The value of FNAC in diagnosis of phyllodes tumour remains controversial, but core needle biopsy has high sensitivity and negative predictive value. Surgical management is the mainstay and local recurrence in phyllodes tumours has been associated with inadequate local excision. The role of adjuvant radiotherapy and chemotherapy remains uncertain and use of hormonal therapy has not been fully investigated. Conclusion. The preoperative diagnosis and proper management are crucial in phyllodes tumours because of their tendency to recur and malignant potential in some of these tumours.

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Available from: Shashi Prakash Mishra
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    • "Phyllodes tumor should be treated by wide surgical excision with clear margin whereas fibroadenoma is effectively managed by simple enucleation [27]. Also it has a tendency to recur, metastasize regardless of its histology and malignant potential in some of cases [28,29]. Therefore, we considered and analyzed benign phyllodes tumor as borderline lesion. "
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    ABSTRACT: Purpose: To evaluate the accuracy of benign core biopsy of probably benign breast lesions (category 3) 2 cm or larger on the basis of excisional biopsy and long-term follow-up. Methods: We retrospectively reviewed 146 category 3 lesions in 146 patients 2 cm or larger which were diagnosed as benign by ultrasound (US)-guided core biopsy. Patients were initially diagnosed as benign at core needle biopsy and then followed up with excisional biopsy (surgical excision, n=91; US-guided vacuum assisted excision, n=35) or breast ultrasonography (n=20). Results: Of the 126 patients who underwent surgical excision or US-guided vacuum-assisted excision, 114 patients were diagnosed with benign lesions, 10 patients with borderline lesions (benign phyllodes tumor), and two patients with malignant phyllodes tumors. The probabilities of lesions being benign, borderline and malignant were 91.8% (134/146), 6.8% (10/146), and 1.4% (2/146), respectively. Of 13 patients who had growing masses on follow-up ultrasonography, three (23.1%) were non-benign (two benign phyllodes tumors and one malignant phyllodes tumor). Conclusion: US-guided core needle biopsy of probably benign breast mass 2 cm or larger was accurate (98.6%) enough to rule out malignancy. But, it was difficult to rule out borderline lesions even when they were diagnosed as benign.
    Full-text · Article · Jul 2014
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    ABSTRACT: Background Data from the literature suggests that the clinical picture of phyllodes tumor (PT) of the breast, as well as treatment options and perhaps therapy outcomes, have significantly changed. The aim of this work was to review these changes by analysis of consecutive patients with PT over a 55-year period at a single institution. Material/Methods From 1952 to 2007, 280 women with PT were treated surgically at the Maria Skłodowska-Curie Memorial Institute of Oncology, Cancer Center in Cracow. Age, size of breast tumor, microscopic type, extent of surgery, and therapy outcomes were compared between 2 groups: 190 patients treated from 1952 to 1991 vs 90 patients treated from 1992 to 2007. Results The results show that the 1992–2007 group compared to the 1952–1991 included more patients <50 years of age, with tumor <5 cm in diameter, undergoing breast-conserving therapy, as well as no evidence of disease at 5-year survival had increased and this change was statistically significant. In addition, malignant PT cases had decreased in frequency. Conclusions The results of this study show that patients with PT are increasingly younger, the breast tumors at diagnosis are smaller, malignant PT is becoming less frequent, and BCT is now the treatment of choice. Most importantly, the general treatment outcomes are significantly better.
    Preview · Article · Dec 2013 · Medical science monitor: international medical journal of experimental and clinical research
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    ABSTRACT: Malignant Phyllodes Tumour (MPT) is considered to be a rare disease of the breast. The most frequent clinical presentation of a MPT is a rapidly growing breast lump. Consecutive cases of MPT registered between Jan 1, 1995 and Dec 31, 2012 at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, were reviewed, to obtain information on age, tumour size, treatment given, disease-free survival, and overall survival. Disease-free survival was computed between the dates of surgery and recurrence, whereas, the overall survival time between the dates of diagnosis and last contact, both in months. A total of 101 cases of Phyllodes tumour were recorded. These included: malignant tumours (42) benign (27), and borderline (32). Malignant Phyllodes tumours (42 cases) were studied further and 41 included for additional analysis. The mean age of the women in the study was 40.3 +/- 12.5 (22-72 years). Of the 33 patients who were disease-free after surgery, 15 had a recurrence, whereas, 18 did not have a recurrence. In those who had surgery alone versus those who received radiation treatment in addition to surgery, the median disease-free survival was 117 and 44.2 months, respectively. The mean overall survival time was 33.7 months. In this study, patients presented at a younger age than in other studies. Further exploration into molecular, biologic, geographic, and socioeconomic factors is needed to clearly understand the epidemiology of this disease in our population.
    Full-text · Article · Mar 2014 · Journal of Ayub Medical College, Abbottabad: JAMC
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