Phyllodes Tumors Introduction

Rodrigo Arrangoiz MS, MD, FACS, FSSO

images

  • Phyllodes tumors:Are true fibroepithelial neoplasms:With both epithelial and stromal components
      • They represent less than 1% of all breast tumors:Most commonly occurring in women in their 50sThey are rapidly growing tumors:But are usually well-defined / circumscribed:Often appear as distinct masses:Indistinguishable from fibroadenomas on mammography and ultrasound

images

    • The World Health Organization has divided phyllodes tumors into three categories: BenignBorderline
      • Malignant

10314-PB3-R1

    • The majority of phyllodes tumors are benign:With local recurrence rates of 15% to 20% depending on adequacy of excision
    • Grading is usually based on multiple criteria in the stromal component:Nuclear pleomorphismMitotic rate
      • Stromal overgrowth
      • Cellularity
      • Tumor margins
    • The distinction between cellular fibroadenomas and phyllodes tumors:Can be difficult
    • The definition of “optimal” margin varies for various types of phyllodes tumors:Historically, margins of 2 cm to 3 cm have been recommended:But current recommendations are considerably less:With the only “absolute” being that the margin is tumor-free
    • Malignant transformation:Is a rare occurrence
    • Metastases can occur:In a small number of malignant phyllodes tumors and an even smaller number of borderline phyllodes tumors
    • Radiotherapy may be of benefit for local control of malignant phyllodes tumors
    • Differences in grading of phyllodes tumors among pathologists can be substantial

REFERENCES

  1. Barth RJ Jr, Wells WA, Mitchell SE, et al. A prospective, multi-institutional study of adjuvant radiotherapy after resection of malignant phyllodes tumors. Ann Surg Oncol. 2009;16:2288-2294.
  2. Lawton TJ, Acs G, Argani P, et al. Interobserver variability by pathologists in the distinction between cellular fibroadenomas and phyllodes tumors. Int J Surg Pathol. 2014;22:695-698.
  3. O’Malley F, Pinder S, Mulligan A, eds.. Fibroepithelial lesions, including fibroadenoma and phyllodes tumors. In: Breast pathology: a volume in the series: foundations in diagnostic pathology, 2nd ed. Philadelphia, PA: Elsevier Saunders; 2011:121-138.
  4. Pezner RD, Schultheiss TE, Paz IB. Malignant phyllodes tumor of the breast: local control rates with surgery alone. Int J Radiat Oncol Biol Phys. 2008;71:710-713.
  5. Sinn H, Kreipe H. A brief overview of the WHO classification of breast tumors, 4th edition, focusing on issues and updates from the 3rd edition. Breast Care (Basel). 2013;8:149-154.
  6. Spitaleri G, Toesca A, Botteri E, et al. Breast phyllodes tumor: a review of literature and a single center retrospective series analysis. Crit Rev Oncol Hematol. 2013;88 :427-436.

👉Member of the American Society of Breast Surgeons:

#Arrangoiz #PhyllodesTumors

#Surgeon #CancerSurgeon

#Cirujano #Surgeon

#SurgicalOncologist

#CirujanoOncologo

#BreastSurgeon

#CirujanodeMama

#CancerSurgeon

#CirujanodeCancer

#MountSinaiMedicalCenter #MSMC #Miami #Mexico

Unknown's avatar

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

Leave a comment