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
- Friable mass
- Well-defined margins
- On microscopic histopathological analysis,characteristic findings of phyllodes tumor, include:
- Large slit-like spaces
- Cellular myxoid stroma
- +/-Infiltrative border
- Stromal overgrowth
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 a breast mass, 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.