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

• On microscopic histopathological analysis,characteristic findings of phyllodes tumor, include:

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 [clinical feature 1], [clinical feature 2], and [clinical feature 3], 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.