Symptoma

Phyllodes Tumor of the Breast

Breast Cystosarcoma Phyllodes

Phyllodes tumor of the breast is a neoplastic disorder of the breast tissue. Benign, malignant, and borderline types have all been described in the literature. A round, painless, mobile mass that is usually several centimeters in diameter is the typical finding, while very large tumors (up to 30-40 cm) are described in 20% of cases. The initial diagnosis can be made through a proper physical examination, but imaging studies (ultrasonography and mammography) and a histopathological evaluation of the lesion are crucial for confirming phyllodes tumor of the breast.

Phyllodes tumor of the breast is a rare entity in clinical practice, and benign (most common), borderline, or malignant variants exist in the literature [1]. Contrary to the majority of breast malignancies that develop in the glandular and ductal tissues, this tumor originates in the fibroepithelial connective tissue and is most frequently described in middle-aged women between 35-55 years of age, although females of all ages may be affected [1] [2] [3] [4] [5] [6]. The presentation is distinguished by the presence of a rapidly growing, mobile, painless, and round mass (lump) that is approximately several centimeters in diameter [1] [3] [7]. However, a growing number of reports documented very large diameters of the phyllodes tumor of the breast, reaching up to 40 centimeters, in which case the term giant phyllodes tumor is used [1] [3]. The lesion is almost always confined to a single breast, and the outer upper quadrant is identified as the predominant location [3]. Additional signs include dilation of skin and cutaneous veins overlying the tumor, sometimes accompanied by ulceration of the skin [3]. The sudden growth of the tumor after several years of relatively stable diameter increase is typically reported by many patients [3] [7]. A bilateral occurrence and retraction of the nipple are rare, but possible manifestations of this tumor [3]. In approximately 10-15% of cases, proximal axillary lymphadenopathy is observed [3].

  • Plethora

    Recently investigators have reported a plethora of genetic changes in phyllodes tumors, the most consistent of which seems to be 1q gain by comparative genomic hybridization. [ncbi.nlm.nih.gov]

  • Axillary Mass

    Axillary mass was not found. Laboratory data revealed that CBC (complete blood count), PT, PTT, Blood Sugar, Urea, Cr, AST, ALT, Alkaline phosphatase, Albumin, Bilirubin, Na, K and Ca were normal. The patient underwent surgery on April 27 th, 2017. [pubs.sciepub.com]

  • Breast Mass

    A 43-year-old woman was referred to our institute because of a left breast mass which was diagnosed as FA clinically. During the follow-up, the mass gradually enlarged and excisional biopsy was performed to rule out malignant lesion. [ncbi.nlm.nih.gov]

  • Neglect

    The largest and neglected giant phyllodes tumor of the breast-A case report and literature review. Int J Surg Case Rep. 2016; 26: 96 100. In article View Article PubMed [8] Testori A, Meroni S, Errico V, Travaglini R, Voulaz E, Alloisio M. [pubs.sciepub.com]

  • Giddiness

    CNS metastasis of phyllodes tumor is rare and associated with a poor prognosis. [1], [2] Case report A 41-year-old female patient presented with progressively increasing headache, vomiting, and giddiness for 7 days. [cancerjournal.net]

The initial diagnosis of a breast lump can be made during a properly performed physical examination, during which inspection and systematic palpation of both breasts are crucial for early recognition. If supported by a thorough patient history, important for gathering information about the progression of the lump and the appearance of additional symptoms, the physical exam provides sufficient clues to further investigate the lump through imaging studies. Ultrasonography and mammography are the optimal methods for the evaluation of breast tumors, typical findings being a well-defined, round or lobulated lesion with a heterogeneous appearance [3] [6] [8] [9]. A more solid diagnosis of phyllodes tumor of the breast can be made when the lump possesses an echogenic rim and contains fluid-filled clefts without microcalcifications [3]. Doppler ultrasonography is also advocated by some authors [3], together with computed tomography and magnetic resonance imaging (CT and MRI, respectively) [1] [7] [8] [9]. To confirm the exact type, a histopathological evaluation is necessary. Fine needle aspiration and core needle biopsy are two options for obtaining a viable sample for testing [7].

  • Lymphocytic Infiltrate

    BRCA1-associated carcinomas are poorly differentiated infiltrating ductal carcinomas frequently exhibiting morphologic features of typical or atypical medullary carcinomas such as prominent lymphocytic infiltrate and pushing margins. [ncbi.nlm.nih.gov]

Adjuvant treatment of malignant phyllodes tumor needs to be investigated. [ncbi.nlm.nih.gov]

Our experience indicated that surgical treatment of malignant phyllodes tumor might be an option for improving patients' quality of life, regardless of the extremely poor prognosis. Breast, Malignant phyllodes tumor, Surgical treatment. [ncbi.nlm.nih.gov]

It is foreseeable that more exciting data will be generated to help us to understand the etiology and pathogenesis of phyllodes tumor. [ncbi.nlm.nih.gov]

Causes - Cystosarcoma phyllodes breast The etiology of CSP is unknown. Prevention - Cystosarcoma phyllodes breast Not supplied. Diagnosis - Cystosarcoma phyllodes breast Prognosis - Cystosarcoma phyllodes breast Not supplied. [checkorphan.org]

Though exact etiology for development of phyllodes tumor in the male breast is unknown, hormonal imbalance with excess of estrogen action relative to androgen appears to have signifi cant association. [content.iospress.com]

The etiology of PTs is poorly understood, but most patients present clinically with a breast mass that is painless and rapidly growing. The texture of PTs is smooth, sharply demarcated and freely moveable. [news-medical.net]

Epidemiology 1% of breast tumors Average age 45 years (age 25 - 30 years in Asians, Aust N Z J Surg 1988;58:301 ) Rare in children or men (gynecomastia is more likely) More common in Hispanics, particularly if born in Latin America ( Cancer 1993;71:3020 ) Etiology [pathologyoutlines.com]

METHODS: Using the Surveillance, Epidemiology, and End Results Program (SEER) database (1983-2013), clinico-pathologic prognostic factors were evaluated. [ncbi.nlm.nih.gov]

Epidemiology PTs occur predominantly in women who are between the fourth and sixth decades of life. A few cases are seen in adolescent girls, but these are rare. The peak incidence occurs around the age of 45, in the perimenopausal period. [news-medical.net]

The descriptive epidemiology of malignant cystosarcoma phyllodes tumors of the breast. Cancer 1993; 71(10):3020-4. Statistics Article View: 764 PDF Download: 533 [ijp.iranpath.org]

Malignant phyllodes tumor of the female breast: association of primary therapy with cause-specific survival from the Surveillance, Epidemiology, and End Results (SEER) program. [jtd.amegroups.com]

Pathophysiology In contrast to breast carcinomas, PTs tend to originate outside the breast lobules and ducts, and within the connective tissue of the breast. [news-medical.net]

Pathophysiology and Etiology Phyllodes tumor is the most commonly occurring nonepithelial neoplasm of the breast, though it represents only about 1% of tumors in the breast. [3] It has a smooth, sharply demarcated texture and typically is freely movable [emedicine.medscape.com]

Prevention - Cystosarcoma phyllodes breast Not supplied. Diagnosis - Cystosarcoma phyllodes breast Prognosis - Cystosarcoma phyllodes breast Not supplied. [checkorphan.org]

Surgical decompression with or without radiation is the best modality of treatment to relieve pain, regain neurological functions and prevent disease progression. [minervamedica.it]

A physical examination a mammogram an ultrasound MRI biopsy (core needle, or excisional) How to prevent a Phyllodes Tumor? Local therapy is aimed at preventing the tumor from coming back in the breast. [breast-cancer.ca]

Now we have begun a second study to see if focusing the radiation on just part of the breast-around the site where the tumor was removed, rather than radiating the entire breast-is equally effective in preventing the recurrence of phyllodes tumors. [cancer.dartmouth.edu]

  1. Testori A, Meroni S, Errico V, Travaglini R, Voulaz E, Alloisio M. Huge malignant phyllodes breast tumor: a real entity in a new era of early breast cancer. World J Surg Oncol. 2015;13:81.
  2. Tan BY, Acs G, Apple SK, et al. Phyllodes tumours of the breast: a consensus review. Histopathology. 2016;68(1):5-21.
  3. Mishra SP, Tiwary SK, Mishra M, Khanna AK. Phyllodes Tumor of Breast: A Review Article. ISRN Surg. 2013;2013:361469.
  4. Ossa CA, Herazo F, Gil M, et al. Phyllodes tumor of the breast: a clinic-pathologic study of 77 cases in a Hispanic cohort. Colomb Med (Cali). 2015;46(3):104-108.
  5. Majeski J, Stroud J. Malignant Phyllodes Tumors of the Breast: A Study in Clinical Practice. Int Surg. 2012;97(2):95-98.
  6. Benhassouna J, Damak T, Gamoudi A, et al. Phyllodes tumors of the breast: a case series of 106 patients. Am J Surg. 2006;192(2):141–147.
  7. Zhou Z-R, Wang C-C, Yang Z-Z, Yu X-L, Guo X-M. Phyllodes tumors of the breast: diagnosis, treatment and prognostic factors related to recurrence. J Thorac Dis. 2016;8(11):3361-3368.
  8. Wurdinger S, Herzog AB, Fischer DR, et al. Differentiation of phyllodes breast tumors from fibroadenomas on MRI. AJR Am J Roentgenol. 2005;185(5):1317–1321.
  9. Feder JM, de Paredes ES, Hogge JP, Wilken JJ. Unusual breast lesions: radiologic-pathologic correlation. Radiographics. 1999;19: S11–S26.