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malignant phyllodes work up

Valerie Cui Yun Koh, Aye Aye Thike, Nur Diyana Md Nasir, George Wai Cheong Yip, Boon Huat Bay, Puay Hoon Tan
Phyllodes tumours (PTs) of the breast are uncommon fibroepithelial neoplasms comprising 0.3-1.0% of all primary breast tumours. The majority of PTs are benign and generally well managed with surgery. However, malignant PTs, and occasionally borderline PTs, can behave in a clinically aggressive manner by metastasizing to distant organs. Although distant metastasis is rare, the prognosis of patients with metastasis is dismal as many are unresponsive to standard chemotherapy and the risk of death is high. In this study, we correlated clinicopathological parameters to survival outcomes in a cohort of patients diagnosed with malignant PTs in our institution...
November 10, 2017: Virchows Archiv: An International Journal of Pathology
Nancy Panko, Anwar A Jebran, Ameer Gomberawalla, Mark Connolly
BACKGROUND Phyllodes tumor (PT) is a rare neoplasm of the breast. Concomitant PT with invasive ductal carcinoma (IDC) is an even rarer occurrence. When ductal carcinoma in situ (DCIS) or IDC are detected within the specimen, the management changes from wide local excision to further staging work-up, including sentinel node biopsy and radiation. CASE REPORT We report the case of a 70-year-old presented with right breast mass whose pathology showed benign PT with concomitant IDC and DCIS. The patient elected for a wide excision of the mass with sentinel lymph node biopsy, which did not show any involvement...
July 20, 2017: American Journal of Case Reports
Emad A Rakha, Mohamed A Ahmed, Mohammed A Aleskandarany, Zsolt Hodi, Andrew H S Lee, Sarah E Pinder, Ian O Ellis
AIMS: Previous concordance studies examining accuracy of breast diagnosis by pathologists, typically targeting difficult, histologically challenging breast lesions using artificial and restrictive environments, have reported aberrantly high levels of diagnostic discordance. The results of these studies may be misinterpreted by non-pathologists and raise concerns relating to routine practice. This study aims to assess the diagnostic agreement among UK breast pathologists. METHODS: Two hundred and forty consecutive breast lesions, submitted by participants from their routine practice, included in the UK National Health Service Breast Screening Programme (NHSBSP) breast pathology EQA scheme during the last 10 years were reviewed...
March 2017: Histopathology
Aykut Soyder, Füsun Taşkin, Serdar Ozbas
BACKGROUND: The objectives of this study were to determine the frequency of imaging-histological discordance and to compare the frequency of carcinoma between discordant lesions at ultrasound (US)-guided core needle biopsy. MATERIALS AND METHODS: From November 2009 to June 2012, we performed US-guided 14-gauge core needle biopsies on 989 breast lesions in 961 women. We reviewed 58 (5.8%) cases that had imaging-histological discordance after percutaneous breast biopsy and underwent subsequent excisional biopsy...
February 2015: Breast Care
Sonal Varma, Sandra J Shin
Spindle cell lesions arising in the breast represent reactive, benign, and malignant tumors with overlapping morphologic, clinico-radiologic, and immunohistochemical characteristics. Moreover, common entities comprising this subset are usually uncommon entities in overall prevalence. The combination of such diagnostic "disadvantages" can make the practicing pathologist feel uncertain from the onset of encountering such a case. We hope to dispel some of this discomfort by delineating a simple algorithm that provides structure and direction to the diagnostic work-up...
March 2013: Advances in Anatomic Pathology
G Bernardi, G Cavallaro, M Indinnimeo, A Fiore, L Basso, G D'Ermo, G De Toma, A Cavallaro
INTRODUCTION: Breast phyllodes tumors (PT) are uncommon fibroepithelial lesions having potential malignant features. These tumors have characteristic features, like pleomorphism, mitoses and overgrowth of the stroma with possible infiltrative margins. The clinical behaviour could be unpredictable, since the relatively high recurrence rate despite correct surgical strategy. Conventional diagnostic examinations show high sensitivity and specificity, but cannot demonstrate the differences between benign and malignant PT...
March 2012: Il Giornale di Chirurgia
Yifoong Chia, Aye Aye Thike, Poh Yian Cheok, Luke Yong-Zheng Chong, Gary Man-Kit Tse, Puay Hoon Tan
AIM: To determine the frequency, pattern and distribution of stromal keratin expression in phyllodes tumours if any, which may impact diagnostic approaches. METHODS: The clinicopathological features of 109 phyllodes tumours comprising 70 (64.2%) benign, 30 (27.5%) borderline and nine (8.3%) malignant grades were evaluated, and the immunohistochemical expression of a keratin panel (MNF116, 34βE12, CK7, CK14, AE1/3, Cam5.2), p63 and CD34 in their stromal component was assessed...
April 2012: Journal of Clinical Pathology
K J Chepla, B S Armijo, T A Ponsky, H T Soltanian
Giant fibroadenoma is a rare, benign stromal tumor that typically occurs in adolescent women. This rapidly-growing tumor can result in a significant aesthetic and psychosocial morbidity due to gross asymmetry changes in the overlying skin envelope and concerns about malignancy. On initial work-up this lesion must be differentiated from other rare primary breast tumors, including phyllodes tumor, or metastatic disease. Appropriate treatment of giant fibroadenoma requires surgical excision; however, many surgeons are reluctant to perform a concomitant mastopexy or reconstruction at the time of tumor extirpation...
September 2011: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
F Draghi, L Sabolla, R Campani, G Meloni
Phyllodes tumors are rare fibro-epithelial neoplasms; they may be classified as benign, borderline and malignant according to their histologic features of mitotic index, stroma pleomorphism and lesion outline. Their epidemiology is rather different from that of other breast neoplasms, since these lesions most frequently affect white Latin women 45 to 49 years old. The incidence of metastases is strictly correlated with the degree of histologic aggressiveness, although even small lesions, either borderline or with low malignancy, may metastasize...
May 1996: La Radiologia Medica
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