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Phyllodes tumor

MedGen UID:
1209
•Concept ID:
C0010701
•
Neoplastic Process
Synonyms: Cystosarcoma Phyllodes; Cystosarcoma Phylloides; Phyllodes Tumor; Phyllodes Tumors; Tumor, Phyllodes; Tumors, Phyllodes
 
Monarch Initiative: MONDO:0005078

Definition

A benign, borderline, or malignant fibroepithelial neoplasm arising from the breast and rarely the prostate gland. It may recur following resection. The recurrence rates are higher for borderline and malignant phyllodes tumors. In borderline and malignant phyllodes tumors metastases to distant anatomic sites can occur. The incidence of metastases is higher in malignant phyllodes tumors. [from NCI]

Professional guidelines

PubMed

Breast Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology.
Gradishar WJ, Moran MS, Abraham J, Abramson V, Aft R, Agnese D, Allison KH, Anderson B, Bailey J, Burstein HJ, Chen N, Chew H, Dang C, Elias AD, Giordano SH, Goetz MP, Jankowitz RC, Javid SH, Krishnamurthy J, Leitch AM, Lyons J, McCloskey S, McShane M, Mortimer J, Patel SA, Rosenberger LH, Rugo HS, Santa-Maria C, Schneider BP, Smith ML, Soliman H, Stringer-Reasor EM, Telli ML, Wei M, Wisinski KB, Yeung KT, Young JS, Schonfeld R, Kumar R
J Natl Compr Canc Netw 2024 Jul;22(5):331-357. doi: 10.6004/jnccn.2024.0035. PMID: 39019058
Breast Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology.
Gradishar WJ, Moran MS, Abraham J, Aft R, Agnese D, Allison KH, Anderson B, Burstein HJ, Chew H, Dang C, Elias AD, Giordano SH, Goetz MP, Goldstein LJ, Hurvitz SA, Isakoff SJ, Jankowitz RC, Javid SH, Krishnamurthy J, Leitch M, Lyons J, Mortimer J, Patel SA, Pierce LJ, Rosenberger LH, Rugo HS, Sitapati A, Smith KL, Smith ML, Soliman H, Stringer-Reasor EM, Telli ML, Ward JH, Wisinski KB, Young JS, Burns J, Kumar R
J Natl Compr Canc Netw 2022 Jun;20(6):691-722. doi: 10.6004/jnccn.2022.0030. PMID: 35714673
Phyllodes Tumor of the Breast: Histopathologic Features, Differential Diagnosis, and Molecular/Genetic Updates.
Zhang Y, Kleer CG
Arch Pathol Lab Med 2016 Jul;140(7):665-71. doi: 10.5858/arpa.2016-0042-RA. PMID: 27362571

Recent clinical studies

Etiology

Phyllodes Tumors of the Breast: Canadian National Consensus Document Using Modified Delphi Methodology.
Bogach J, Sriskandarajah A, Wright FC, Look Hong N; Canadian Phyllodes Tumor Consensus Panel
Ann Surg Oncol 2023 Oct;30(11):6386-6397. Epub 2023 Aug 9 doi: 10.1245/s10434-023-13912-7. PMID: 37556009
Management of phyllodes tumor: A systematic review and meta-analysis of real-world evidence.
Yu CY, Huang TW, Tam KW
Int J Surg 2022 Nov;107:106969. Epub 2022 Oct 31 doi: 10.1016/j.ijsu.2022.106969. PMID: 36328344
Malignant phyllodes tumor of the breast: a systematic review.
Lissidini G, Mulè A, Santoro A, Papa G, Nicosia L, Cassano E, Ashoor AA, Veronesi P, Pantanowitz L, Hornick JL, Rossi ED
Pathologica 2022 Apr;114(2):111-120. Epub 2022 Apr 13 doi: 10.32074/1591-951X-754. PMID: 35414723Free PMC Article
Fibroepithelial lesions; The WHO spectrum.
Krings G, Bean GR, Chen YY
Semin Diagn Pathol 2017 Sep;34(5):438-452. Epub 2017 May 28 doi: 10.1053/j.semdp.2017.05.006. PMID: 28688536
Phyllodes Tumor of the Breast: Histopathologic Features, Differential Diagnosis, and Molecular/Genetic Updates.
Zhang Y, Kleer CG
Arch Pathol Lab Med 2016 Jul;140(7):665-71. doi: 10.5858/arpa.2016-0042-RA. PMID: 27362571

Diagnosis

Phyllodes Tumors of the Breast: Canadian National Consensus Document Using Modified Delphi Methodology.
Bogach J, Sriskandarajah A, Wright FC, Look Hong N; Canadian Phyllodes Tumor Consensus Panel
Ann Surg Oncol 2023 Oct;30(11):6386-6397. Epub 2023 Aug 9 doi: 10.1245/s10434-023-13912-7. PMID: 37556009
Management of Stromal Lesions.
Yu J, Kansal K
Surg Clin North Am 2022 Dec;102(6):1017-1030. doi: 10.1016/j.suc.2022.07.002. PMID: 36335922
Malignant phyllodes tumor of the breast: a systematic review.
Lissidini G, Mulè A, Santoro A, Papa G, Nicosia L, Cassano E, Ashoor AA, Veronesi P, Pantanowitz L, Hornick JL, Rossi ED
Pathologica 2022 Apr;114(2):111-120. Epub 2022 Apr 13 doi: 10.32074/1591-951X-754. PMID: 35414723Free PMC Article
Fibroepithelial lesions; The WHO spectrum.
Krings G, Bean GR, Chen YY
Semin Diagn Pathol 2017 Sep;34(5):438-452. Epub 2017 May 28 doi: 10.1053/j.semdp.2017.05.006. PMID: 28688536
Phyllodes Tumor of the Breast: Histopathologic Features, Differential Diagnosis, and Molecular/Genetic Updates.
Zhang Y, Kleer CG
Arch Pathol Lab Med 2016 Jul;140(7):665-71. doi: 10.5858/arpa.2016-0042-RA. PMID: 27362571

Therapy

Precise diagnosis of breast phyllodes tumors using Raman spectroscopy: Biochemical fingerprint, tumor metabolism and possible mechanism.
Wu Y, Wang Y, He C, Wang Y, Ma J, Lin Y, Zhou L, Xu S, Ye Y, Yin W, Ye J, Lu J
Anal Chim Acta 2023 Dec 1;1283:341897. Epub 2023 Oct 15 doi: 10.1016/j.aca.2023.341897. PMID: 37977771
Management of Stromal Lesions.
Yu J, Kansal K
Surg Clin North Am 2022 Dec;102(6):1017-1030. doi: 10.1016/j.suc.2022.07.002. PMID: 36335922
Nonepithelial malignancies of the breast.
Chugh R, Baker L
Oncology (Williston Park) 2004 May;18(5):665-73; discussion 673-6. PMID: 15209192
Phyllodes tumors of the breast.
Khan SA, Badve S
Curr Treat Options Oncol 2001 Apr;2(2):139-47. doi: 10.1007/s11864-001-0056-y. PMID: 12057132
Benign breast disease.
Hamed H, Fentiman IS
Int J Clin Pract 2001 Sep;55(7):461-4. PMID: 11594256

Prognosis

CD146 promotes malignant progression of breast phyllodes tumor through suppressing DCBLD2 degradation and activating the AKT pathway.
Chen J, Xu Q, Liu D, Li X, Guo M, Chen X, Liao J, Lei R, Li W, Huang H, Saw PE, Song E, Yan X, Nie Y
Cancer Commun (Lond) 2023 Nov;43(11):1244-1266. Epub 2023 Oct 19 doi: 10.1002/cac2.12495. PMID: 37856423Free PMC Article
Refining the classification of breast phyllodes tumours.
Tan PH
Pathology 2023 Jun;55(4):437-448. Epub 2023 Mar 21 doi: 10.1016/j.pathol.2023.02.001. PMID: 37085395
Management of Stromal Lesions.
Yu J, Kansal K
Surg Clin North Am 2022 Dec;102(6):1017-1030. doi: 10.1016/j.suc.2022.07.002. PMID: 36335922
Management of phyllodes tumor: A systematic review and meta-analysis of real-world evidence.
Yu CY, Huang TW, Tam KW
Int J Surg 2022 Nov;107:106969. Epub 2022 Oct 31 doi: 10.1016/j.ijsu.2022.106969. PMID: 36328344
Fibroepithelial lesions; The WHO spectrum.
Krings G, Bean GR, Chen YY
Semin Diagn Pathol 2017 Sep;34(5):438-452. Epub 2017 May 28 doi: 10.1053/j.semdp.2017.05.006. PMID: 28688536

Clinical prediction guides

CD146 promotes malignant progression of breast phyllodes tumor through suppressing DCBLD2 degradation and activating the AKT pathway.
Chen J, Xu Q, Liu D, Li X, Guo M, Chen X, Liao J, Lei R, Li W, Huang H, Saw PE, Song E, Yan X, Nie Y
Cancer Commun (Lond) 2023 Nov;43(11):1244-1266. Epub 2023 Oct 19 doi: 10.1002/cac2.12495. PMID: 37856423Free PMC Article
Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions).
Elfgen C, Leo C, Kubik-Huch RA, Muenst S, Schmidt N, Quinn C, McNally S, van Diest PJ, Mann RM, Bago-Horvath Z, Bernathova M, Regitnig P, Fuchsjäger M, Schwegler-Guggemos D, Maranta M, Zehbe S, Tausch C, Güth U, Fallenberg EM, Schrading S, Kothari A, Sonnenschein M, Kampmann G, Kulka J, Tille JC, Körner M, Decker T, Lax SF, Daniaux M, Bjelic-Radisic V, Kacerovsky-Strobl S, Condorelli R, Gnant M, Varga Z
Virchows Arch 2023 Jul;483(1):5-20. Epub 2023 Jun 17 doi: 10.1007/s00428-023-03566-x. PMID: 37330436Free PMC Article
Management of Stromal Lesions.
Yu J, Kansal K
Surg Clin North Am 2022 Dec;102(6):1017-1030. doi: 10.1016/j.suc.2022.07.002. PMID: 36335922
Fibroepithelial lesions; The WHO spectrum.
Krings G, Bean GR, Chen YY
Semin Diagn Pathol 2017 Sep;34(5):438-452. Epub 2017 May 28 doi: 10.1053/j.semdp.2017.05.006. PMID: 28688536
Phyllodes tumours of the breast: a consensus review.
Tan BY, Acs G, Apple SK, Badve S, Bleiweiss IJ, Brogi E, Calvo JP, Dabbs DJ, Ellis IO, Eusebi V, Farshid G, Fox SB, Ichihara S, Lakhani SR, Rakha EA, Reis-Filho JS, Richardson AL, Sahin A, Schmitt FC, Schnitt SJ, Siziopikou KP, Soares FA, Tse GM, Vincent-Salomon A, Tan PH
Histopathology 2016 Jan;68(1):5-21. doi: 10.1111/his.12876. PMID: 26768026Free PMC Article

Recent systematic reviews

Metastatic and Malignant Phyllodes Tumors of the Breast: An Update for Current Management.
Goodwin B, Oyinlola AF, Palhang M, Lehman D, Platoff R, Atabek U, Spitz F, Hong Y
Am Surg 2023 Dec;89(12):6190-6196. Epub 2023 Aug 23 doi: 10.1177/00031348231198114. PMID: 37611540
Management of phyllodes tumor: A systematic review and meta-analysis of real-world evidence.
Yu CY, Huang TW, Tam KW
Int J Surg 2022 Nov;107:106969. Epub 2022 Oct 31 doi: 10.1016/j.ijsu.2022.106969. PMID: 36328344
Malignant phyllodes tumor of the breast: a systematic review.
Lissidini G, Mulè A, Santoro A, Papa G, Nicosia L, Cassano E, Ashoor AA, Veronesi P, Pantanowitz L, Hornick JL, Rossi ED
Pathologica 2022 Apr;114(2):111-120. Epub 2022 Apr 13 doi: 10.32074/1591-951X-754. PMID: 35414723Free PMC Article
Width of margins in phyllodes tumors of the breast: the controversy drags on?-a systematic review and meta-analysis.
Toussaint A, Piaget-Rossel R, Stormacq C, Mathevet P, Lepigeon K, Taffé P
Breast Cancer Res Treat 2021 Jan;185(1):21-37. Epub 2020 Sep 15 doi: 10.1007/s10549-020-05924-8. PMID: 32935237
Phyllodes Tumor of the Breast during Pregnancy and Lactation; A Systematic Review.
Alipour S, Eskandari A, Johar FM, Furuya S
Arch Iran Med 2020 Jul 1;23(7):488-497. doi: 10.34172/aim.2020.46. PMID: 32657600

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