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Histopathology. 2016 Jan;68(1):5-21. doi: 10.1111/his.12876.

Phyllodes tumours of the breast: a consensus review.

Author information

1
Department of Pathology, Singapore General Hospital, Singapore.
2
Women's Pathology Consultants, Ruffolo Hooper & Associates, Tampa, FL, USA.
3
Department of Pathology, UCLA Medical Center, Santa Monica, CA, USA.
4
Departments of Pathology and Internal Medicine, Clarian Pathology Laboratory of Indiana University, Indianapolis, IN, USA.
5
Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
6
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
7
Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid, Spain.
8
University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
9
Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.
10
Sezione Anatomia e Istologia Patologica, 'M. Malpighi' Università di Bologna, Bologna, Italy.
11
BreastScreen SA, Discipline of Medicine, Adelaide University and Directorate of Surgical Pathology, SA Pathology, Adelaide, South Australia.
12
Pathology Department, Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Vic., Australia.
13
Department of Pathology, Nagoya Medical Center, Nagoya, Japan.
14
School of Medicine and Pathology Queensland, The Royal Brisbane & Women's Hospital, University of Queensland Centre for Clinical Research, Brisbane, Qld, Australia.
15
Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
16
Department of Pathology, Division of Pathology/Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
17
Laboratoire national de santé, Luxembourg city, Luxembourg.
18
Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
19
Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.
20
Department of Anatomic Pathology, A. C. Camargo Cancer Centre, São Paulo, Brazil.
21
Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
22
Pôle Pathologie-Génétique-Immunologie, Institut Curie, Paris, France.

Abstract

Phyllodes tumours constitute an uncommon but complex group of mammary fibroepithelial lesions. Accurate and reproducible grading of these tumours has long been challenging, owing to the need to assess multiple stratified histological parameters, which may be weighted differently by individual pathologists. Distinction of benign phyllodes tumours from cellular fibroadenomas is fraught with difficulty, due to overlapping microscopic features. Similarly, separation of the malignant phyllodes tumour from spindle cell metaplastic carcinoma and primary breast sarcoma can be problematic. Phyllodes tumours are treated by surgical excision. However, there is no consensus on the definition of an appropriate surgical margin to ensure completeness of excision and reduction of recurrence risk. Interpretive subjectivity, overlapping histological diagnostic criteria, suboptimal correlation between histological classification and clinical behaviour and the lack of robust molecular predictors of outcome make further investigation of the pathogenesis of these fascinating tumours a matter of active research. This review consolidates the current understanding of their pathobiology and clinical behaviour, and includes proposals for a rational approach to the classification and management of phyllodes tumours.

KEYWORDS:

classification; fibroadenoma; malignant; metastasis; phyllodes

PMID:
26768026
PMCID:
PMC5027876
DOI:
10.1111/his.12876
[Indexed for MEDLINE]
Free PMC Article

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