Definitions

Phyllodes_tumor

Phyllodes tumor

Phyllodes tumors (from Greek: phullon leaf), also cystosarcoma phyllodes, cystosarcoma phylloides and phylloides tumor, are typically large, fast growing masses that form from the periductal stroma of the breast. They account for less than 1% of all breast neoplasms.

Classification

Phyllodes tumors are a fibroepithelial tumor composed of an epithelial and a cellular stromal component. They may be considered benign, borderline, or malignant depending on histologic features including stromal cellularity, infiltration at the tumor's edge, and mitotic activity. All forms of phyllodes tumors are considered breast cancer, as even the benign form is regarded as having malignant potential.

They are classified as a fibroepithelial tumor by ICD-O, but not by MeSH.

Presentation

This is predominantly a tumor of adult women, with very few examples reported in adolescents. Patients typically present with a firm, palpable mass. These tumors are very fast growing, and can increase in size in just a few weeks. Occurrence is most common between the ages of 40 and 50, prior to the menopause. This is about 15 years older than the typical age of patients with fibroadenoma, a condition with which Phyllodes tumors may be confused.

Treatment

The common treatment for phyllodes is wide local excision. Other than surgery, there is no cure for phyllodes, as chemotherapy & radiation therapy are not effective. The risk of developing local recurrence or metastases is related to the histologic grade, according to the above-named features.

One study has suggested that total mastectomy is more effective than breast-conserving surgery.

Spectrum

Phyllodes tumors are considered to be on a spectrum of disease that consists of fibroadenoma, fibroadenoma variant and benign phyllodes. Some would extend the spectrum to include malignant phyllodes tumors and frank sarcoma.

References

External links

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