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2016 ; 68
(1
): 5-21
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Phyllodes tumours of the breast: a consensus review
#MMPMID26768026
Tan BY
; Acs G
; Apple SK
; Badve S
; Bleiweiss IJ
; Brogi E
; Calvo JP
; Dabbs DJ
; Ellis IO
; Eusebi V
; Farshid G
; Fox SB
; Ichihara S
; Lakhani SR
; Rakha EA
; Reis-Filho JS
; Richardson AL
; Sahin A
; Schmitt FC
; Schnitt SJ
; Siziopikou KP
; Soares FA
; Tse GM
; Vincent-Salomon A
; Tan PH
Histopathology
2016[Jan]; 68
(1
): 5-21
PMID26768026
show ga
Phyllodes tumours constitute an uncommon but complex group of mammary
fibroepithelial lesions. Accurate and reproducible grading of these tumours has
long been challenging, owing to the need to assess multiple stratified
histological parameters, which may be weighted differently by individual
pathologists. Distinction of benign phyllodes tumours from cellular fibroadenomas
is fraught with difficulty, due to overlapping microscopic features. Similarly,
separation of the malignant phyllodes tumour from spindle cell metaplastic
carcinoma and primary breast sarcoma can be problematic. Phyllodes tumours are
treated by surgical excision. However, there is no consensus on the definition of
an appropriate surgical margin to ensure completeness of excision and reduction
of recurrence risk. Interpretive subjectivity, overlapping histological
diagnostic criteria, suboptimal correlation between histological classification
and clinical behaviour and the lack of robust molecular predictors of outcome
make further investigation of the pathogenesis of these fascinating tumours a
matter of active research. This review consolidates the current understanding of
their pathobiology and clinical behaviour, and includes proposals for a rational
approach to the classification and management of phyllodes tumours.