Diagnosis and Treatment of Phyllode Tumor of Breast / 解放军医学杂志

Objective To study the histopathological features, diagnosis criteria, the relationship of surgery pattern and prognosis of phyllode tumor of breast. Methods To analyze the histopathological features and clinical outcome of different surgery patterns in 203 patients with phyllode tumor of breast by Chi square test, Cluster, Focater, Logistic and Cox multivariate regression according to the request of SPSS 10. 0. Results 203 patients with phyllode tumor of breast were divided into three groups, i.e. benign 133 cases, borderline 42 cases and malignant 28 cases. Local recurrences in three groups were 28, 19 and 18, respectively. The patients died from tumor were 0, 2 and 16, and circulatory metastases were 0, 1 and 10, respectively. Five-year survival were 100 %,92. 0% and 33. 3% in the three groups of 131 patients by a 5 years' follow-up survey. Conclusions Tumor necrosis has important value in the diagnosis of phyllode tumor. Nature of tumor margin, cellular pleomorphism, frequency of mitoses and tumor necrosis were statistically appropriate composition in histological diagnosis of phyllode tumor. Wide local excision is preferred for the benign and borderline phyllode tumor, while simple mastectomy is indicated for recurred borderline and malignant, but tylectomy should be abolished in the treatment of phyllode tumor. Correlation of histotypes of phyllode tumor with local recurrence and tumor death was statistically significant at a level of P＜0. 001; correlation of infiltrative growth of the tumor with local recurrence was statistically significant at a level of P＜0. 001. Tumor necrosis and mitotic activity were independent prognostic factors.

Clinicopathological study on phyllodes tumor of the breast / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the relationship between pathological features and classification criteria of the breast Phyllodes tumor.</p><p><b>METHODS</b>203 cases of breast phyllodes tumor diagnosed in 22 hospitals since 1956 were analyzed and reappraised by a retrospective study.</p><p><b>RESULTS</b>133 cases were benign, 42 cases were borderline and 28 were malignant. The follow-up (6 to 372 months) showed that 28/133 benign, 19/42 borderline and 18/28 malignant cases recurred, and 17 patients (2 borderline and 15 malignant) died. The statistic cluster analysis demonstrated that stromal cellar atypia, margin involvement, mitotic activity and tumor necrosis were retained in the variable group, and no error distinguish were showed.</p><p><b>CONCLUSIONS</b>The breast phyllodes tumor can be classified as the following three types: benign, borderline and malignant. It is important to diagnose and classify the breast phyllodes tumor according to the involvement of tumor margin, stromal cellar atypia, mitotic activity, stromal overgrowth and tumor necrosis. There are significant differences of 5 years survival rates, recurrent rates and death rates between the benign, borderline and malignant breast phyllodes tumor. With wide excision the recurrence of the tumor decreased suggesting that broad excision is preferred for the benign phyllodes tumor and mastectomy is indicated for recurred borderline and malignant tumors.</p>

The treatment and prognosis of patients with phyllodes tumor of the breast / 中国普通外科杂志

ObjectiveTo study the treatment and prognosis of the breast phyllodes tumors.MethodsKG1Clinical data, and the results of follow-up in 203 cases of breast phyllodes tumors were analyzed using Logistic analysis and Cox regression in SPSS statistic software.ResultWT5”BZLocal recurrence and tumor mortality were in direct proportion to the pathologic grade of the tumor. There was a direct proportion between local recurrence and tumor infiltration; and between tumor caused-mortality and tumor mitosis and necrosis.Mitotic activity and tumor necrosis were the independent prognostic factors. After surgical resection 21 1% of patients with benign tumor, 45 2% of patients with borderline tumor, 64 3% of patients with malignant tumor suffered recurrence. The 5-year survival rate was 100% in patients with benign phyllodes tumor, 92 0% with borderline tumor, and 33 3% with malignance.KG2Conclusion Local excision is not the appropriate treatment for phyllodes tumor. Patients with benign or borderline phyllodes tumor should undergo wide local excision including a margin of uninvolved tissue, and that with local recurrent borderline and malignant phyllodes tumor receive mastectomy.