Phyllodes tumor

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Synonyms and keywords: Cystosarcoma phyllodes;

Overview

Phyllodes tumor (also known as cystosarcoma phyllodes), is a typically large, fast-growing mass that arises from the periductal stromal cells of the breast. Phyllodes tumors account for less than 1% of all breast neoplasms.

Historical Perspective

  • Phyllodes tumor was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].

Classification

  • Phyllodes tumor may be classified according to [classification method] into [number] subtypes/groups:
  • [group1]
  • [group2]
  • [group3]
  • Other variants of phyllodes tumor include [disease subtype 1], [disease subtype 2], and [disease subtype 3].

Pathophysiology

  • The pathogenesis of phyllodes tumor is characterized by [feature1], [feature2], and [feature3].
  • Genes involved in the development of phyllodes tumor, include:
  • On gross pathology, characteristic findings of phyllodes tumor, include:
  • Cleft/leaf-like structures
  • Friable mass
  • Well-defined margins
  • On microscopic histopathological analysis,characteristic findings of phyllodes tumor, include:
  • Large slit-like spaces
  • Cellular myxoid stroma
  • +/-Infiltrative border
  • Stromal overgrowth

Causes

  • There are no established causes for phyllodes tumor.

Differentiating Phyllodes Tumor from Other Diseases

  • Phyllodes tumor must be differentiated from other diseases that cause a breast mass, such as:
  • [Differential dx1]
  • [Differential dx2]
  • [Differential dx3]

Epidemiology and Demographics

  • The prevalence of phyllodes tumor is approximately [number or range] per 100,000 individuals worldwide.
  • In [year], the incidence of phyllodes tumor was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

  • Patients of all age groups may develop phyllodes tumor.

Gender

  • Females are more commonly affected with phyllodes tumor than males.

Race

  • There is no racial predilection for phyllodes tumor.

Risk Factors

  • Common risk factors in the development of phyllodes tumor, include:

Natural History, Complications and Prognosis

  • The majority of patients with phyllodes tumor remain asymptomatic for [duration/years].
  • Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
  • If left untreated, [#%] of patients with phyllodes tumor may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of phyllodes tumor include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with phyllodes tumor is approximately [#%].

Diagnosis

Diagnostic Criteria

  • The diagnosis of phyllodes tumor is made with biopsy.

Symptoms

  • Phyllodes tumor is usually asymptomatic.
  • Symptoms of phyllodes tumor may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with phyllodes tumor usually appear [general appearance].
  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with phyllodes tumor.
  • A [positive/negative] [test name] is diagnostic of phyllodes tumor.
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of phyllodes tumor.
  • Other laboratory findings consistent with the diagnosis of phyllodes tumor include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings

  • [Imaging study 1] is the imaging modality of choice for phyllodes tumor.
  • On [imaging study 1], findings of phyllodes tumor include:

Treatment

Medical Therapy

  • The mainstay of therapy for phyllodes tumor is [medical therapy 1] and [medical therapy 2].

Surgery

  • Surgery is the mainstay of therapy for phyllodes tumor.
  • [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of phyllodes tumor.
  • [Surgical procedure] can only be performed for patients with [disease stage] phyllodes tumor.

Prevention

  • Effective measures for the primary prevention of phyllodes tumor include periodical self-breast examination, and routine mammography.
  • Once diagnosed and successfully treated, patients with phyllodes tumor are followed-up periodically.
  • Follow-up testing, includes: ultrasound examination.

References