Phyllodes tumours of the breast: a consensus review
Identifieur interne : 001958 ( Main/Exploration ); précédent : 001957; suivant : 001959Phyllodes tumours of the breast: a consensus review
Auteurs : Benjamin Y. Tan ; Geza Acs [États-Unis] ; Sophia K. Apple [États-Unis] ; Sunil Badve [États-Unis] ; Ira J. Bleiweiss [États-Unis] ; Edi Brogi [États-Unis] ; José P. Calvo [Espagne] ; David J. Dabbs [États-Unis] ; Ian O. Ellis [Royaume-Uni] ; Vincenzo Eusebi [Italie] ; Gelareh Farshid [Australie] ; Stephen B. Fox [Australie] ; Shu Ichihara [Japon] ; Sunil R. Lakhani [Australie] ; Emad A. Rakha [Royaume-Uni] ; Jorge S. Reis-Filho [États-Unis] ; Andrea L. Richardson [États-Unis] ; Aysegul Sahin [États-Unis] ; Fernando C. Schmitt [Luxembourg (pays)] ; Stuart J. Schnitt [États-Unis] ; Kalliopi P. Siziopikou [États-Unis] ; Fernando A. Soares [Brésil] ; Gary M. Tse [Hong Kong] ; Anne Vincent-Salomon [France] ; Puay Hoon TanSource :
- Histopathology [ 0309-0167 ] ; 2016.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Carcinomes, Fibroadénome, Région mammaire, Sarcomes, Tumeur phyllode, Tumeurs du sein.
- Consensus, Diagnostic différentiel, Femelle, Humains.
English descriptors
- KwdEn :
- MESH :
- pathology : Breast, Breast Neoplasms, Carcinoma, Fibroadenoma, Phyllodes Tumor, Sarcoma.
- Consensus, Diagnosis, Differential, Female, Humans.
Abstract
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.
Url:
DOI: 10.1111/his.12876
PubMed: 26768026
PubMed Central: 5027876
Affiliations:
- Australie, Brésil, Espagne, France, Hong Kong, Italie, Japon, Luxembourg (pays), Royaume-Uni, États-Unis
- Australie-Méridionale, Californie, Communauté de Madrid, Floride, Illinois, Indiana, Massachusetts, Pennsylvanie, Texas, Émilie-Romagne, État de New York, État de São Paulo, Île-de-France
- Bologne, Madrid, Paris, Sha Tin, São Paulo
- Université chinoise de Hong Kong, Université de Bologne
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Le document en format XML
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Rakha</name><affiliation wicri:level="1"><nlm:aff id="A9">Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham</wicri:regionArea><wicri:noRegion>Nottingham</wicri:noRegion></affiliation></author><author><name sortKey="Reis Filho, Jorge S" sort="Reis Filho, Jorge S" uniqKey="Reis Filho J" first="Jorge S" last="Reis-Filho">Jorge S. 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Schmitt</name><affiliation wicri:level="1"><nlm:aff id="A17">Laboratoire national de santé, Luxembourg city, Luxembourg</nlm:aff><country xml:lang="fr">Luxembourg (pays)</country><wicri:regionArea>Laboratoire national de santé, Luxembourg city</wicri:regionArea><wicri:noRegion>Luxembourg city</wicri:noRegion></affiliation></author><author><name sortKey="Schnitt, Stuart J" sort="Schnitt, Stuart J" uniqKey="Schnitt S" first="Stuart J" last="Schnitt">Stuart J. Schnitt</name><affiliation wicri:level="2"><nlm:aff id="A18">Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Siziopikou, Kalliopi P" sort="Siziopikou, Kalliopi P" uniqKey="Siziopikou K" first="Kalliopi P" last="Siziopikou">Kalliopi P. Siziopikou</name><affiliation wicri:level="2"><nlm:aff id="A19">Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Northwestern University Feinberg School of Medicine, Robert H. 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Tse</name><affiliation wicri:level="4"><nlm:aff id="A21">Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Vincent Salomon, Anne" sort="Vincent Salomon, Anne" uniqKey="Vincent Salomon A" first="Anne" last="Vincent-Salomon">Anne Vincent-Salomon</name><affiliation wicri:level="3"><nlm:aff id="A22">Pôle Pathologie-Génétique-Immunologie, Institut Curie, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Pôle Pathologie-Génétique-Immunologie, Institut Curie, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Tan, Puay Hoon" sort="Tan, Puay Hoon" uniqKey="Tan P" first="Puay Hoon" last="Tan">Puay Hoon Tan</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26768026</idno><idno type="pmc">5027876</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027876</idno><idno type="RBID">PMC:5027876</idno><idno type="doi">10.1111/his.12876</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">001F74</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001F74</idno><idno type="wicri:Area/Pmc/Curation">001E28</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001E28</idno><idno type="wicri:Area/Pmc/Checkpoint">000707</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000707</idno><idno type="wicri:source">PubMed</idno><idno type="wicri:Area/PubMed/Corpus">002363</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002363</idno><idno type="wicri:Area/PubMed/Curation">002331</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">002331</idno><idno type="wicri:Area/PubMed/Checkpoint">002331</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">002331</idno><idno type="wicri:Area/Ncbi/Merge">002F92</idno><idno type="wicri:Area/Ncbi/Curation">002F92</idno><idno type="wicri:Area/Ncbi/Checkpoint">002F92</idno><idno type="wicri:doubleKey">0309-0167:2016:Tan B:phyllodes:tumours:of</idno><idno type="wicri:Area/Main/Merge">001953</idno><idno type="wicri:Area/Main/Curation">001958</idno><idno type="wicri:Area/Main/Exploration">001958</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Phyllodes tumours of the breast: a consensus review</title><author><name sortKey="Tan, Benjamin Y" sort="Tan, Benjamin Y" uniqKey="Tan B" first="Benjamin Y" last="Tan">Benjamin Y. Tan</name></author><author><name sortKey="Acs, Geza" sort="Acs, Geza" uniqKey="Acs G" first="Geza" last="Acs">Geza Acs</name><affiliation wicri:level="2"><nlm:aff id="A2">Women’s Pathology Consultants, Ruffolo Hooper & Associates, Tampa, FL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Women’s Pathology Consultants, Ruffolo Hooper & Associates, Tampa, FL</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Apple, Sophia K" sort="Apple, Sophia K" uniqKey="Apple S" first="Sophia K" last="Apple">Sophia K. Apple</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Pathology, UCLA Medical Center, Santa Monica, CA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, UCLA Medical Center, Santa Monica, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Badve, Sunil" sort="Badve, Sunil" uniqKey="Badve S" first="Sunil" last="Badve">Sunil Badve</name><affiliation wicri:level="2"><nlm:aff id="A4">Departments of Pathology and Internal Medicine, Clarian Pathology Laboratory of Indiana University, Indianapolis, IN, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Departments of Pathology and Internal Medicine, Clarian Pathology Laboratory of Indiana University, Indianapolis, IN</wicri:regionArea><placeName><region type="state">Indiana</region></placeName></affiliation></author><author><name sortKey="Bleiweiss, Ira J" sort="Bleiweiss, Ira J" uniqKey="Bleiweiss I" first="Ira J" last="Bleiweiss">Ira J. Bleiweiss</name><affiliation wicri:level="2"><nlm:aff id="A5">Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Brogi, Edi" sort="Brogi, Edi" uniqKey="Brogi E" first="Edi" last="Brogi">Edi Brogi</name><affiliation wicri:level="2"><nlm:aff id="A6">Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Calvo, Jose P" sort="Calvo, Jose P" uniqKey="Calvo J" first="José P" last="Calvo">José P. Calvo</name><affiliation wicri:level="3"><nlm:aff id="A7">Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Dabbs, David J" sort="Dabbs, David J" uniqKey="Dabbs D" first="David J" last="Dabbs">David J. Dabbs</name><affiliation wicri:level="2"><nlm:aff id="A8">University of Pittsburgh Medical Center, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Pittsburgh Medical Center, Pittsburgh, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Ellis, Ian O" sort="Ellis, Ian O" uniqKey="Ellis I" first="Ian O" last="Ellis">Ian O. Ellis</name><affiliation wicri:level="1"><nlm:aff id="A9">Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham</wicri:regionArea><wicri:noRegion>Nottingham</wicri:noRegion></affiliation></author><author><name sortKey="Eusebi, Vincenzo" sort="Eusebi, Vincenzo" uniqKey="Eusebi V" first="Vincenzo" last="Eusebi">Vincenzo Eusebi</name><affiliation wicri:level="4"><nlm:aff id="A10">Sezione Anatomia e Istologia Patologica, ‘M. Malpighi’ Università di Bologna, Bologna, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Sezione Anatomia e Istologia Patologica, ‘M. Malpighi’ Università di Bologna, Bologna</wicri:regionArea><orgName type="university">Université de Bologne</orgName><placeName><settlement type="city">Bologne</settlement><region nuts="2" type="region">Émilie-Romagne</region></placeName></affiliation></author><author><name sortKey="Farshid, Gelareh" sort="Farshid, Gelareh" uniqKey="Farshid G" first="Gelareh" last="Farshid">Gelareh Farshid</name><affiliation wicri:level="2"><nlm:aff id="A11">BreastScreen SA, Discipline of Medicine, Adelaide University and Directorate of Surgical Pathology, SA Pathology, Adelaide, South Australia</nlm:aff><country>Australie</country><placeName><region type="state">Australie-Méridionale</region></placeName><wicri:cityArea>BreastScreen SA, Discipline of Medicine, Adelaide University and Directorate of Surgical Pathology, SA Pathology, Adelaide</wicri:cityArea></affiliation></author><author><name sortKey="Fox, Stephen B" sort="Fox, Stephen B" uniqKey="Fox S" first="Stephen B" last="Fox">Stephen B. Fox</name><affiliation wicri:level="1"><nlm:aff id="A12">Pathology Department, Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Vic., Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Pathology Department, Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Vic.</wicri:regionArea><wicri:noRegion>Vic.</wicri:noRegion></affiliation></author><author><name sortKey="Ichihara, Shu" sort="Ichihara, Shu" uniqKey="Ichihara S" first="Shu" last="Ichihara">Shu Ichihara</name><affiliation wicri:level="1"><nlm:aff id="A13">Department of Pathology, Nagoya Medical Center, Nagoya, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Pathology, Nagoya Medical Center, Nagoya</wicri:regionArea><wicri:noRegion>Nagoya</wicri:noRegion></affiliation></author><author><name sortKey="Lakhani, Sunil R" sort="Lakhani, Sunil R" uniqKey="Lakhani S" first="Sunil R" last="Lakhani">Sunil R. Lakhani</name><affiliation wicri:level="1"><nlm:aff id="A14">School of Medicine and Pathology Queensland, The Royal Brisbane & Women’s Hospital, University of Queensland Centre for Clinical Research, Brisbane, Qld, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>School of Medicine and Pathology Queensland, The Royal Brisbane & Women’s Hospital, University of Queensland Centre for Clinical Research, Brisbane, Qld</wicri:regionArea><wicri:noRegion>Qld</wicri:noRegion></affiliation></author><author><name sortKey="Rakha, Emad A" sort="Rakha, Emad A" uniqKey="Rakha E" first="Emad A" last="Rakha">Emad A. Rakha</name><affiliation wicri:level="1"><nlm:aff id="A9">Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham</wicri:regionArea><wicri:noRegion>Nottingham</wicri:noRegion></affiliation></author><author><name sortKey="Reis Filho, Jorge S" sort="Reis Filho, Jorge S" uniqKey="Reis Filho J" first="Jorge S" last="Reis-Filho">Jorge S. Reis-Filho</name><affiliation wicri:level="2"><nlm:aff id="A6">Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Richardson, Andrea L" sort="Richardson, Andrea L" uniqKey="Richardson A" first="Andrea L" last="Richardson">Andrea L. Richardson</name><affiliation wicri:level="2"><nlm:aff id="A15">Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Sahin, Aysegul" sort="Sahin, Aysegul" uniqKey="Sahin A" first="Aysegul" last="Sahin">Aysegul Sahin</name><affiliation wicri:level="2"><nlm:aff id="A16">Department of Pathology, Division of Pathology/Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, Division of Pathology/Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Schmitt, Fernando C" sort="Schmitt, Fernando C" uniqKey="Schmitt F" first="Fernando C" last="Schmitt">Fernando C. Schmitt</name><affiliation wicri:level="1"><nlm:aff id="A17">Laboratoire national de santé, Luxembourg city, Luxembourg</nlm:aff><country xml:lang="fr">Luxembourg (pays)</country><wicri:regionArea>Laboratoire national de santé, Luxembourg city</wicri:regionArea><wicri:noRegion>Luxembourg city</wicri:noRegion></affiliation></author><author><name sortKey="Schnitt, Stuart J" sort="Schnitt, Stuart J" uniqKey="Schnitt S" first="Stuart J" last="Schnitt">Stuart J. Schnitt</name><affiliation wicri:level="2"><nlm:aff id="A18">Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Siziopikou, Kalliopi P" sort="Siziopikou, Kalliopi P" uniqKey="Siziopikou K" first="Kalliopi P" last="Siziopikou">Kalliopi P. Siziopikou</name><affiliation wicri:level="2"><nlm:aff id="A19">Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Soares, Fernando A" sort="Soares, Fernando A" uniqKey="Soares F" first="Fernando A" last="Soares">Fernando A. Soares</name><affiliation wicri:level="3"><nlm:aff id="A20">Department of Anatomic Pathology, A. C. Camargo Cancer Centre, São Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Anatomic Pathology, A. C. Camargo Cancer Centre, São Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Tse, Gary M" sort="Tse, Gary M" uniqKey="Tse G" first="Gary M" last="Tse">Gary M. Tse</name><affiliation wicri:level="4"><nlm:aff id="A21">Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong</nlm:aff><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Vincent Salomon, Anne" sort="Vincent Salomon, Anne" uniqKey="Vincent Salomon A" first="Anne" last="Vincent-Salomon">Anne Vincent-Salomon</name><affiliation wicri:level="3"><nlm:aff id="A22">Pôle Pathologie-Génétique-Immunologie, Institut Curie, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Pôle Pathologie-Génétique-Immunologie, Institut Curie, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Tan, Puay Hoon" sort="Tan, Puay Hoon" uniqKey="Tan P" first="Puay Hoon" last="Tan">Puay Hoon Tan</name></author></analytic><series><title level="j">Histopathology</title><idno type="ISSN">0309-0167</idno><idno type="eISSN">1365-2559</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Breast (pathology)</term><term>Breast Neoplasms (pathology)</term><term>Carcinoma (pathology)</term><term>Consensus</term><term>Diagnosis, Differential</term><term>Female</term><term>Fibroadenoma (pathology)</term><term>Humans</term><term>Phyllodes Tumor (pathology)</term><term>Sarcoma (pathology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Carcinomes (anatomopathologie)</term><term>Consensus</term><term>Diagnostic différentiel</term><term>Femelle</term><term>Fibroadénome (anatomopathologie)</term><term>Humains</term><term>Région mammaire (anatomopathologie)</term><term>Sarcomes (anatomopathologie)</term><term>Tumeur phyllode (anatomopathologie)</term><term>Tumeurs du sein (anatomopathologie)</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Carcinomes</term><term>Fibroadénome</term><term>Région mammaire</term><term>Sarcomes</term><term>Tumeur phyllode</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast</term><term>Breast Neoplasms</term><term>Carcinoma</term><term>Fibroadenoma</term><term>Phyllodes Tumor</term><term>Sarcoma</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Consensus</term><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Consensus</term><term>Diagnostic différentiel</term><term>Femelle</term><term>Humains</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1">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.</p></div></front></TEI><affiliations><list><country><li>Australie</li><li>Brésil</li><li>Espagne</li><li>France</li><li>Hong Kong</li><li>Italie</li><li>Japon</li><li>Luxembourg (pays)</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Australie-Méridionale</li><li>Californie</li><li>Communauté de Madrid</li><li>Floride</li><li>Illinois</li><li>Indiana</li><li>Massachusetts</li><li>Pennsylvanie</li><li>Texas</li><li>Émilie-Romagne</li><li>État de New York</li><li>État de São Paulo</li><li>Île-de-France</li></region><settlement><li>Bologne</li><li>Madrid</li><li>Paris</li><li>Sha Tin</li><li>São Paulo</li></settlement><orgName><li>Université chinoise de Hong Kong</li><li>Université de Bologne</li></orgName></list><tree><noCountry><name sortKey="Tan, Benjamin Y" sort="Tan, Benjamin Y" uniqKey="Tan B" first="Benjamin Y" last="Tan">Benjamin Y. Tan</name><name sortKey="Tan, Puay Hoon" sort="Tan, Puay Hoon" uniqKey="Tan P" first="Puay Hoon" last="Tan">Puay Hoon Tan</name></noCountry><country name="États-Unis"><region name="Floride"><name sortKey="Acs, Geza" sort="Acs, Geza" uniqKey="Acs G" first="Geza" last="Acs">Geza Acs</name></region><name sortKey="Apple, Sophia K" sort="Apple, Sophia K" uniqKey="Apple S" first="Sophia K" last="Apple">Sophia K. Apple</name><name sortKey="Badve, Sunil" sort="Badve, Sunil" uniqKey="Badve S" first="Sunil" last="Badve">Sunil Badve</name><name sortKey="Bleiweiss, Ira J" sort="Bleiweiss, Ira J" uniqKey="Bleiweiss I" first="Ira J" last="Bleiweiss">Ira J. Bleiweiss</name><name sortKey="Brogi, Edi" sort="Brogi, Edi" uniqKey="Brogi E" first="Edi" last="Brogi">Edi Brogi</name><name sortKey="Dabbs, David J" sort="Dabbs, David J" uniqKey="Dabbs D" first="David J" last="Dabbs">David J. Dabbs</name><name sortKey="Reis Filho, Jorge S" sort="Reis Filho, Jorge S" uniqKey="Reis Filho J" first="Jorge S" last="Reis-Filho">Jorge S. Reis-Filho</name><name sortKey="Richardson, Andrea L" sort="Richardson, Andrea L" uniqKey="Richardson A" first="Andrea L" last="Richardson">Andrea L. Richardson</name><name sortKey="Sahin, Aysegul" sort="Sahin, Aysegul" uniqKey="Sahin A" first="Aysegul" last="Sahin">Aysegul Sahin</name><name sortKey="Schnitt, Stuart J" sort="Schnitt, Stuart J" uniqKey="Schnitt S" first="Stuart J" last="Schnitt">Stuart J. Schnitt</name><name sortKey="Siziopikou, Kalliopi P" sort="Siziopikou, Kalliopi P" uniqKey="Siziopikou K" first="Kalliopi P" last="Siziopikou">Kalliopi P. Siziopikou</name></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Calvo, Jose P" sort="Calvo, Jose P" uniqKey="Calvo J" first="José P" last="Calvo">José P. Calvo</name></region></country><country name="Royaume-Uni"><noRegion><name sortKey="Ellis, Ian O" sort="Ellis, Ian O" uniqKey="Ellis I" first="Ian O" last="Ellis">Ian O. Ellis</name></noRegion><name sortKey="Rakha, Emad A" sort="Rakha, Emad A" uniqKey="Rakha E" first="Emad A" last="Rakha">Emad A. Rakha</name></country><country name="Italie"><region name="Émilie-Romagne"><name sortKey="Eusebi, Vincenzo" sort="Eusebi, Vincenzo" uniqKey="Eusebi V" first="Vincenzo" last="Eusebi">Vincenzo Eusebi</name></region></country><country name="Australie"><region name="Australie-Méridionale"><name sortKey="Farshid, Gelareh" sort="Farshid, Gelareh" uniqKey="Farshid G" first="Gelareh" last="Farshid">Gelareh Farshid</name></region><name sortKey="Fox, Stephen B" sort="Fox, Stephen B" uniqKey="Fox S" first="Stephen B" last="Fox">Stephen B. Fox</name><name sortKey="Lakhani, Sunil R" sort="Lakhani, Sunil R" uniqKey="Lakhani S" first="Sunil R" last="Lakhani">Sunil R. Lakhani</name></country><country name="Japon"><noRegion><name sortKey="Ichihara, Shu" sort="Ichihara, Shu" uniqKey="Ichihara S" first="Shu" last="Ichihara">Shu Ichihara</name></noRegion></country><country name="Luxembourg (pays)"><noRegion><name sortKey="Schmitt, Fernando C" sort="Schmitt, Fernando C" uniqKey="Schmitt F" first="Fernando C" last="Schmitt">Fernando C. Schmitt</name></noRegion></country><country name="Brésil"><region name="État de São Paulo"><name sortKey="Soares, Fernando A" sort="Soares, Fernando A" uniqKey="Soares F" first="Fernando A" last="Soares">Fernando A. Soares</name></region></country><country name="Hong Kong"><noRegion><name sortKey="Tse, Gary M" sort="Tse, Gary M" uniqKey="Tse G" first="Gary M" last="Tse">Gary M. Tse</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Vincent Salomon, Anne" sort="Vincent Salomon, Anne" uniqKey="Vincent Salomon A" first="Anne" last="Vincent-Salomon">Anne Vincent-Salomon</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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