Phyllodes Tumor of the Breast: Stromal Overgrowth and Histological Classification are Useful Prognosis-predictive Factors for Local Recurrence in Patients with a Positive Surgical Margin

Dentistry Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata, Okayama 700-8558, Japan.
Japanese Journal of Clinical Oncology (Impact Factor: 2.02). 11/2007; 37(10):730-6. DOI: 10.1093/jjco/hym099
Source: PubMed


Background The local recurrence rate of phyllodes tumors is high and ensuring a sufficient surgical margin is considered important for
local control. However, the preoperative diagnosis rate of phyllodes tumors is low and we often encounter cases in which a
sufficient surgical margin is not achieved, since in routine medical practice the lesion may not be diagnosed as phyllodes
tumor until postoperative biopsy of a mammary mass. Furthermore, there are no established therapeutic guidelines for surgical
stump-positive phyllodes tumors. We reviewed the outcomes of excision of phyllodes tumors to investigate factors involved
in local recurrence and to determine the indication for re-excision in stump-positive cases.

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    • "Distant metastasis rates of up to 17% have been reported, mostly from borderline or malignant tumours. Many suggested histological prognostic factors for distant metastases have been evaluated, including stromal overgrowth, infiltrating margins, mixed mesenchymal components, high mitotic rate and stromal atypia[3]. All of these were absent in this patient. "

    Full-text · Article · Jan 2015
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    • "Twenty percent of tumours grow larger than 10 cm- the arbitrary cut-off point for designation as a giant tumour [1-3]. Studies have shown no difference between breast- conserving surgery versus mastectomy in terms of metastases free-survival or overall survival despite the higher incidence of local recurrence that comes with breast-conserving surgery [4,5]. Arguments for over- and under- treating these patients remain due to the difficulty of forming a clear diagnostic and therapeutic pathway in this highly variable disease. "
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    ABSTRACT: Background The controversy between breast conserving surgery and simple mastectomy for phyllodes tumours of the breast remains because of the unpredictable nature of the disease. Although some benign tumours may show an unusually aggressive behaviour, modified radical surgery for phyllodes tumours offers no survival advantage, and recently more conservative surgical approaches have been deployed. Case presentation A 30-year-old woman with a giant multifocal tumour of the breast underwent breast-conserving surgery that made use of the well- circumscribed feature of the tumour. The case demonstrates the safety, and cosmetic benefit of the breast-conserving approach for multifocal phyllodes tumours except for the high recurrence rate. Conclusions Large size, multifocality, and borderline or malignant histology are contraindications for breast-conserving surgery.
    Full-text · Article · Jul 2014 · World Journal of Surgical Oncology
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    • "This possibility could not be excluded since treatment with control virus was not assessed in the systemic approach. Also, in some tumors, only a small proportion of cells are malignant [43], [44], while the rest are murine-derived stromal (not permissive for adenovirus replication) and the latter would remain after oncolysis. "
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    ABSTRACT: Oncolytic adenoviruses can be engineered for better tumor selectivity, gene delivery and be armed for imaging and concentrating radionuclides into tumors for synergistic oncolysis. We constructed Ad5/3-hTERT-hNIS where replication is controlled by hTERT-promoter. Ad5/3-hTERT-hNIS expresses hNIS for imaging of transgene expression and for treatment of infected tumors by radioiodine. Ad5/3-hTERT-hNIS efficiently killed prostate cancer cells and induced iodine uptake in vitro and in vivo after intratumoral virus administration. Survival of mice treated with intravenous Ad5/3-hTERT-hNIS significantly prolonged survival over mock or radioiodine only but the combination of virus with radioiodine was not more effective than virus alone. Temporal and spatial changes in hNIS-expression during therapy were detected with SPECT, demonstrating feasibility of evaluation of the combination therapy with hNIS-expressing adenoviruses and radioiodide.
    Full-text · Article · Mar 2012 · PLoS ONE
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