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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

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
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

Race-Related Differences in the Clinical Presentation and Histopathologic Features of Phyllodes Tumor.
Johnson HM, Mohamed A, Hassan MM, Geradts J, Geisel L, Vohra NA, Wong JH
Am Surg 2023 Mar;89(3):407-413. Epub 2021 Jun 30 doi: 10.1177/00031348211029841. PMID: 34190619
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
Spindle cell lesions of the breast: a diagnostic approach.
Rakha EA, Brogi E, Castellano I, Quinn C
Virchows Arch 2022 Jan;480(1):127-145. Epub 2021 Jul 29 doi: 10.1007/s00428-021-03162-x. PMID: 34322734Free PMC Article
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

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
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
Radiopathological characteristics and outcomes of phyllodes tumor of the breast in Malaysian women.
Abdul Hamid S, Rahmat K, Ramli MT, Fadzli F, Jamaris S, See MH, Teoh KH, Taib NAM
Medicine (Baltimore) 2018 Aug;97(31):e11412. doi: 10.1097/MD.0000000000011412. PMID: 30075507Free PMC Article
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
Phyllodes tumours.
Parker SJ, Harries SA
Postgrad Med J 2001 Jul;77(909):428-35. doi: 10.1136/pmj.77.909.428. PMID: 11423590Free PMC Article

Therapy

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
MRI-based radiomics analysis for differentiating phyllodes tumors of the breast from fibroadenomas.
Tsuchiya M, Masui T, Terauchi K, Yamada T, Katyayama M, Ichikawa S, Noda Y, Goshima S
Eur Radiol 2022 Jun;32(6):4090-4100. Epub 2022 Jan 19 doi: 10.1007/s00330-021-08510-8. PMID: 35044510
BCDnet: Parallel heterogeneous eight-class classification model of breast pathology.
He Q, Cheng G, Ju H
PLoS One 2021;16(7):e0253764. Epub 2021 Jul 12 doi: 10.1371/journal.pone.0253764. PMID: 34252112Free PMC Article
Outcomes of systemic therapy in metastatic phyllodes tumor of the breast.
Parkes A, Wang WL, Patel S, Leung CH, Lin H, Conley AP, Somaiah N, Araujo DM, Zarzour M, Livingston JA, Ludwig J, Roland CL, Ravi V, Benjamin RS, Ratan R
Breast Cancer Res Treat 2021 Apr;186(3):871-882. Epub 2021 Feb 11 doi: 10.1007/s10549-021-06116-8. PMID: 33575859
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 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
Phyllodes tumour among participants in screening mammography.
Farshid G, Gill PG
ANZ J Surg 2017 Dec;87(12):E285-E292. Epub 2015 Mar 19 doi: 10.1111/ans.13056. PMID: 25786884
Phyllodes tumours.
Parker SJ, Harries SA
Postgrad Med J 2001 Jul;77(909):428-35. doi: 10.1136/pmj.77.909.428. PMID: 11423590Free PMC Article

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
Cytological Findings in Benign Phyllodes Tumors.
Kumar PV, Mokhtari M
Acta Cytol 2019;63(1):23-27. Epub 2018 Oct 26 doi: 10.1159/000493677. PMID: 30368498
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
Surgical margins for borderline and malignant phyllodes tumours.
Thind A, Patel B, Thind K, Isherwood J, Phillips B, Dhaliwal K, Remoundos DD
Ann R Coll Surg Engl 2020 Mar;102(3):165-173. Epub 2020 Jan 10 doi: 10.1308/rcsann.2019.0140. PMID: 31918563Free PMC Article

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