Phyllodes breast tumors
Authors:
I. Zedníková 1; M. Černá 1; M. Hlaváčková 2; O. Hes 3
Authors place of work:
Chirurgická klinika FN Plzeň-Lochotín, přednosta: prof. MUDr. V. Třeška, DrSc.
1; Klinika zobrazovacích metod FN Plzeň-Lochotín, přednosta: prof. MUDr. B. Kreuzberg, CSc.
2; Šiklův patologicko-anatomický ústav FN Plzeň, přednosta: prof. MUDr. M. Michal
3
Published in the journal:
Rozhl. Chir., 2015, roč. 94, č. 1, s. 4-7.
Category:
Review
Summary
Introduction:
Phyllodes tumour is a breast tumour occurring very rarely. It accounts for only in 1% of all cases of breast tumour. The diagnosis of phyllodes tumours can be difficult in consideration of the small number of cases. Treatment of phyllodes tumours is always surgical.
Methods:
In 2004–2013, we operated on twelve female patients with phyllodes tumours out of the total number of 1564 surgeries for breast tumours (0.8%) at the Department of Surgery at Teaching Hospital in Pilsen. We evaluated the age, the biological behaviour of the tumour depending on the tumour size and duration, the distant metastases, therapy and survival.
Results:
The average age at the time of surgery was fifty years (26−84), the duration of disease to the surgical solution ranged from one month to ten years. Tumour size was in the range of two to twenty-nine centimetres, tumours measuring less than five centimetres were always benign. Tumour excision for benign phyllodes tumour was performed seven times. Malignant phyllodes tumour was diagnosed five times with mastectomy performed in each case, and the axilla was exenterated in three cases where nodes were benign in each of them. In one case, mastectomy was followed by radiotherapy because the tumour reached the edge of the resected part; the other patients were only monitored. In two patients, tumour spreading into the lungs was diagnosed at five to ten months after breast surgery. One patient with generalized disease died, the other ones live with no local recurrence of this disease. Median survival is fifty-two months; the disease-free interval is fifty months.
Conclusion:
The results show that if phyllodes tumour is diagnosed in time, it is almost exclusively benign. If the case history is longer and the tumour is growing, the likelihood of malignancy increases. Surgical treatment is also sufficient in the case of malignant forms. The breast surgery does not need to be supplemented with exenteration of axilla.
Key words:
breast – phyllodes tumour
Zdroje
1. Carter BA, Page DL. Phyllodes tumor of the breast: local recurrence versus metastatic capacity. Hum Pathol 2004;35:1051−1052.
2. Kraemer B, Hoffmann J, Roehm C, et al. Cystosarcoma phyllodes of the breast: a rare diagnosis: case studies and review of literature. Arch Gynecol Obstet 2007;276:649−53.
3. Lee AH, Hodi Z, Ellis I, et al. Histological features useful in the distinction of phyllodes tumour and fibroadenoma on needle core biopsy of the breast. Histopathology 2007;51:336−44.
4. Sůvová B, Linhartová A. Karcinom prsu ve fyloidním nádoru. Klinická onkologie. 1992;5:149–153.
5. Khan SA, Badve S. Phyllodes tumors of the breast. Ann surg 2004;11:1011−1017.
6. Grau AM, Chakravarthy AB, Chugh R. Phyllodes tumours of the breast. 1. www.uptodate.com/contents/phyllodes-tumors-of-the-breast. 2010; April 11.
7. Bella V, Bellová L. Fyloidný tumor. Onkológia (Bratisl.) 2011;6:278–280.
8. Chen WH, Cheng SP, Tzen CY, et al. Surgical treatment of phyllodes tumors of the breast: retrospective review of 172 cases. J Surg Oncol 2005;91:185−94.
9. Yohe S, Yeh IT. Missed diagnoses of phyllodes tumor on breast biopsy: pathologic clues to its recognition. Int J Surg Pathol 2008;16:137−42.
10. 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;71:710−13.
11. Lenhard MS, Kahlert S, Himsl I, et al. Phyllodes tumour of the breast: clinical follow-up of 33 cases of this rare disease. Eur J Obstet Gynecol Reprod Biol 2008;138:217−21.
12. Kraemer B, Hoffmann J, Roehm C, et al. Cystosarcoma phyllodes of the breast: a rare diagnosis: case studies and review of literature. Arch Gynecol Obstet 2007;276:649−53.
13. Kinkor Z, Sticová E, Šach J, Rychtera J, Skálová A. Sarkomatoidní (metaplastický) vřetenobuněčný karcinom prsu vznikající ve fyloidním tumoru s rozsáhlou skvamózní metaplázií – kazuistika a přehled literatury. Cesk Patol 2012;48:156–60.
14. Shirah GR, Lau SK, Jayaram L, Bouton ME, Patel PN. Invasive lobular carcinoma and lobular carcinoma in situ in a phyllodes tumor. Breast J 2011;17:307–9.
15. Sharma R, Usmani S, Siegel R. Primary squamous cell carcinoma of breast in background of phyllodes tumor − a case report. Conn Med 2009;73:341–3.
16. Abdul Aziz M, Sullivan F, Kerin MJ, Callagy G. Malignant phyllodes tumour with liposarcomatous differentiation, invasive tubular carcinoma, and ductal and lobular carcinoma in situ: case report and review of the literature. Patholog Res Int 2010;2010:501274.
17. 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;16:2288−94.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
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