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PloS One 2022To evaluate ultrasound characteristics in the prediction of malignant and benign phyllodes tumor of the breast (PTB) by using Logistic regression analysis.
OBJECTIVE
To evaluate ultrasound characteristics in the prediction of malignant and benign phyllodes tumor of the breast (PTB) by using Logistic regression analysis.
METHODS
79 lesions diagnosed as PTB by pathology were analyzed retrospectively. The ultrasound features of PTB were recorded and compared between benign and malignant tumors by using single factor and multiple stepwise Logistic regression analysis. Moreover, the Logistic regression model for malignancy prediction was also established.
RESULTS
There were 79 patients with PTB, including 39 benign PTBs and 40 malignant PTBs (33 borderline PTBs and 7 malignant PTBs by pathologic classification). The area under the ROC curve (AUC) of lesion size and age were 0.737 and 0.850 respectively. There were significant differences in age, lesion size, shape, internal echo, liquefaction, and blood flow between malignant and benign PTBs by using single-factor analysis (P<0.05). Age, internal echo, and liquefaction were significant features by using Logistic regression analysis. The corresponding regression equation In (p/(1 - p) = -3.676+2.919 internal echo +3.029 liquefaction +4.346 age).
CONCLUSION
Internal echo, age, and liquefaction are independent ultrasound characteristics in predicting the malignancy of PTBs.
Topics: Breast; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Logistic Models; Phyllodes Tumor; Retrospective Studies
PubMed: 35325009
DOI: 10.1371/journal.pone.0265952 -
Cureus Apr 2024In this comprehensive study, we present an exceptionally rare case characterized by the occurrence of multi-recurrent asynchronous bilateral malignant phyllodes tumors....
In this comprehensive study, we present an exceptionally rare case characterized by the occurrence of multi-recurrent asynchronous bilateral malignant phyllodes tumors. Phyllodes tumors, known for their rapid growth, originate within the stromal tissue of the breast and predominantly manifest as benign entities. Our case stands out as an extraordinary anomaly, not only due to its bilateral malignant nature but also owing to the manifestation of a multi-recurrent pattern on both sides. This unprecedented presentation underscores the complexity and heterogeneity of malignant phyllodes tumors, necessitating further in-depth investigation to unravel the underlying mechanisms driving their aggressive behavior and to explore innovative therapeutic strategies aimed at optimizing patient outcomes and prognosis.
PubMed: 38738143
DOI: 10.7759/cureus.57936 -
ANZ Journal of Surgery Jan 2023Optimal and tailored surgical treatment of phyllodes tumour(PT) of the breast is controversial. This study aims to determine the appropriate surgical margin in the...
BACKGROUNDS
Optimal and tailored surgical treatment of phyllodes tumour(PT) of the breast is controversial. This study aims to determine the appropriate surgical margin in the treatment of PT.
METHODOLOGY
The data of 132 patients who underwent breast surgery with the diagnosis of PT at the Breast Unit of Istanbul Faculty of Medicine from 2000 to 2022 were retrospectively reviewed.
RESULTS
Median age was 38 and patients with benign PT were younger than others(median age was 34, 44, and 43 for benign, borderline, and malignant, respectively) (P = 0.001). Local recurrence was observed in 7 (5.3%) patients, systemic recurrence was observed in 3 (2.3%) patients, and disease-related death was observed in 2 (1.5%) patients. Local recurrence occurred in 1.4% (n = 1) of benign tumours, 8.3% (n = 2) of borderline tumours, and 10.3% (n = 4) of malignant tumours. All of the systemic recurrences and deaths were seen in the malignant group. The local recurrence rate was found to be higher in borderline and malignant tumours with surgical margins less than 10 mm (44.4% versus 3.7%, P = 0.003), and tumours larger than 5 cm (11.8% versus 1.3%, P = 0.015). In comparison, there was no correlation between the surgical margin proximity, tumour diameter, and local recurrence rates in benign PT (P > 0.05).
CONCLUSION
According to our findings, negative surgical margins seem to be sufficient in the treatment of benign phyllodes tumours. Furthermore at least 1 cm negative surgical margins must be achieved for malignant and borderline phyllodes tumours to avoid local recurrence.
Topics: Humans; Adult; Female; Phyllodes Tumor; Margins of Excision; Retrospective Studies; Neoplasm Recurrence, Local; Breast Neoplasms
PubMed: 36629354
DOI: 10.1111/ans.18264 -
Surgical Case Reports Apr 2024The age of onset of the phyllodes tumor is generally in the late 40 s, and diagnosis and treatment during pregnancy and lactation are rare. We herein present a case of...
BACKGROUND
The age of onset of the phyllodes tumor is generally in the late 40 s, and diagnosis and treatment during pregnancy and lactation are rare. We herein present a case of a phyllodes tumor that rapidly increased in size during the pregnancy and lactation period.
CASE PRESENTATION
A 39-year-old woman was referred to our hospital with a mass in the right breast that increased in size during the pregnancy and lactation period. On ultrasound (5 week postpartum), a well-defined lobulated mass with internal septations and fluid retention was observed. Magnetic resonance imaging of the breast at 8 week postpartum revealed a 70-mm-sized smooth-margin mass with multilocular cystic components. Marked proliferation of stromal cells with high cell density was observed in a biopsy specimen taken at the previous hospital. We diagnosed the mass as a phyllodes tumor of borderline malignancy and excised it at 13 week postpartum. The excised tumor was 85 mm in diameter and its interior was filled with a milk-like substance. Histologically, there was only a mild increase in stromal cell density but fibrosis with associated degeneration was prominent. The final diagnosis was benign phyllodes tumor with degeneration.
CONCLUSIONS
We report a case of a phyllodes tumor that rapidly increased in size during pregnancy and the lactation period. The accumulation of a milk-like substance was thought to be responsible for the rapid growth of the tumor.
PubMed: 38656672
DOI: 10.1186/s40792-024-01895-w -
Annals of Clinical and Laboratory... Jan 2023Phyllodes tumor (PT) is an uncommon fibroepithelial lesion of the breast. PT can be classified as benign, borderline, and malignant based on semi-quantitative assessment... (Review)
Review
Phyllodes tumor (PT) is an uncommon fibroepithelial lesion of the breast. PT can be classified as benign, borderline, and malignant based on semi-quantitative assessment of stromal hypercellularity and overgrowth, cytologic atypia, mitotic activity, tumor border, and presence of malignant heterologous elements. PT is considered malignant by default, if malignant heterologous elements are encountered. The heterologous elements include liposarcoma, angiosarcoma, osteosarcoma, chondrosarcoma, and rhabdomyosarcoma. Malignant PT (MPT) with rhabdomyosarcomatous component is extremely rare, and only a few cases are reported. Here, we present a case of MPT with mixed osteosarcomatous and rhabdomyosarcomatous elements in a 51-year-old female, with review of the literatures and discussion of the differential diagnosis.
Topics: Female; Humans; Middle Aged; Phyllodes Tumor; Osteosarcoma; Rhabdomyosarcoma; Bone Neoplasms; Breast Neoplasms
PubMed: 36889758
DOI: No ID Found -
The Breast Journal Mar 2020
Topics: Breast; Breast Neoplasms; Diagnosis, Differential; Female; Fibroadenoma; Humans; Phyllodes Tumor
PubMed: 31486153
DOI: 10.1111/tbj.13564 -
Journal of Nuclear Medicine Technology Jun 2023Phyllodes tumor (PT) represents a rare type of breast tumor arising from the stromal component rather than the epithelium. Metastatic spread occurs hematogenously, with...
Phyllodes tumor (PT) represents a rare type of breast tumor arising from the stromal component rather than the epithelium. Metastatic spread occurs hematogenously, with lung, bone, brain, and liver being the most common sites. We present the F-FDG PET/CT scan of one such case of phyllodes tumor showing cardiac and pancreatic metastases, which are an extremely rare occurrence.
Topics: Humans; Female; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Phyllodes Tumor; Tomography, X-Ray Computed; Pancreatic Neoplasms; Breast Neoplasms
PubMed: 36750379
DOI: 10.2967/jnmt.122.265212 -
Pediatrics International : Official... Mar 2021To evaluate the correlation of physical examination, and radiological and pathological findings of children and adolescents with breast-related complaints.
BACKGROUND
To evaluate the correlation of physical examination, and radiological and pathological findings of children and adolescents with breast-related complaints.
METHODS
Children and adolescents with breast complaints between January 2016 and December 2019 were analyzed retrospectively.
RESULTS
A total of 118 children and adolescent patients were included. Their ages ranged from 12 to 18 years (median, 16 years). Twenty-one patients had a family history of breast cancer (17.8%). The most common complaints were pain, mass, and nipple discharge. Physical examination revealed mass (41.5%), tenderness (11%), and fullness (8.5%). Thirty-nine patients were classified ultrasonographically with Breast Imaging Reporting and Data System (BIRADS) 3 (39.4%) and four patients were BIRADS 4 (4%). Excision was applied to all patients with BIRADS 4, and 13 of 39 patients with BIRADS 3. Pathological diagnoses of the patients with BIRADS 3 were fibroadenoma (n: 12, 92.3%) and benign phyllodes tumor (n: 1, 7.7%). In patients with BIRADS 4, three patients had fiboradenomas and one patient had a benign phyllodes tumor. No recurrence was observed in any patients who had an excision. Only six of the patients with positive family history had BIRADS 3 lesions, and the others were BIRADS 1. Excision was recommended in two patients and the pathological diagnoses were fibroadenoma.
CONCLUSION
In this age group, the most common complaints were pain and mass, while physical examination was normal in nearly half of the patients. All of the pathological diagnoses were benign. While evaluating the patients in this age range, the experience of the clinician and radiologist is important and we think that it is necessary to increase the awareness of the patient and family about physiological breast development and self-breast examination.
Topics: Adolescent; Breast; Breast Neoplasms; Child; Female; Fibroadenoma; Humans; Neoplasm Recurrence, Local; Phyllodes Tumor; Retrospective Studies
PubMed: 32745292
DOI: 10.1111/ped.14418 -
European Radiology Jun 2022To evaluate the diagnostic performance of MRI-based radiomics model for differentiating phyllodes tumors of the breast from fibroadenomas.
OBJECTIVES
To evaluate the diagnostic performance of MRI-based radiomics model for differentiating phyllodes tumors of the breast from fibroadenomas.
METHODS
This retrospective study included 88 patients (32 with phyllodes tumors and 56 with fibroadenomas) who underwent MRI. Radiomic features were extracted from T2-weighted image, pre-contrast T1-weighted image, and the first-phase and late-phase dynamic contrast-enhanced MRIs. To create stable machine learning models and balanced classes, data augmentation was performed. A least absolute shrinkage and selection operator (LASSO) regression was performed to select features and build the radiomics model. A radiological model was constructed from conventional MRI features evaluated by radiologists. A combined model was constructed using both radiomics features and radiological features. Machine learning classifications were done using support vector machine, extreme gradient boosting, and random forest. The area under the receiver operating characteristic (ROC) curve (AUC) was computed to assess the performance of each model.
RESULTS
Among 1070 features, the LASSO logistic regression selected 35 features. Among three machine learning classifiers, support vector machine had the best performance. Compared to the radiological model (AUC: 0.77 ± 0.11), the radiomics model (AUC: 0.96 ± 0.04) and combined model (0.97 ± 0.03) had significantly improved AUC values (both p < 0.01) in the validation set. The combined model had a relatively higher AUC than that of the radiomics model in the validation set, but this was not significantly different (p = 0.391).
CONCLUSIONS
Radiomics analysis based on MRI showed promise for discriminating phyllodes tumors from fibroadenomas.
KEY POINTS
• The radiomics model and the combined model were superior to the radiological model for differentiating phyllodes tumors from fibroadenomas. • The SVM classifier performed best in the current study. • MRI-based radiomics model could help accurately differentiate phyllodes tumors from fibroadenomas.
Topics: Breast Neoplasms; Female; Fibroadenoma; Humans; Magnetic Resonance Imaging; Phyllodes Tumor; Retrospective Studies
PubMed: 35044510
DOI: 10.1007/s00330-021-08510-8 -
Der Pathologe Dec 2021In the fifth edition of the World Health Organization (WHO) classification of tumors of the breast, the histological features of the lesions continue to form the basis... (Review)
Review
In the fifth edition of the World Health Organization (WHO) classification of tumors of the breast, the histological features of the lesions continue to form the basis of the classification; however, molecular pathology nowadays provides approaches for improved diagnostics and prediction of prognosis and treatment response, which have been incorporated into the update of the classification. The most important changes are presented, which include changes in the histological classification of invasive carcinomas, the subtyping of lobular carcinoma in situ (LCIS) and the dignity criteria of phyllodes tumors.
Topics: Breast; Breast Neoplasms; Carcinoma; Carcinoma in Situ; Carcinoma, Lobular; Female; Humans; Prognosis; World Health Organization
PubMed: 34751805
DOI: 10.1007/s00292-021-01019-3