Phyllodes tumours of the breast: a consensus review.
Identifieur interne : 002331 ( PubMed/Curation ); précédent : 002330; suivant : 002332Phyllodes tumours of the breast: a consensus review.
Auteurs : Benjamin Y. Tan [Singapour] ; 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 Tan [Singapour]Source :
- Histopathology [ 1365-2559 ] ; 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.
DOI: 10.1111/his.12876
PubMed: 26768026
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<author><name sortKey="Sahin, Aysegul" sort="Sahin, Aysegul" uniqKey="Sahin A" first="Aysegul" last="Sahin">Aysegul Sahin</name>
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<author><name sortKey="Schmitt, Fernando C" sort="Schmitt, Fernando C" uniqKey="Schmitt F" first="Fernando C" last="Schmitt">Fernando C. Schmitt</name>
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<author><name sortKey="Vincent Salomon, Anne" sort="Vincent Salomon, Anne" uniqKey="Vincent Salomon A" first="Anne" last="Vincent-Salomon">Anne Vincent-Salomon</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">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>
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<author><name sortKey="Acs, Geza" sort="Acs, Geza" uniqKey="Acs G" first="Geza" last="Acs">Geza Acs</name>
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<author><name sortKey="Apple, Sophia K" sort="Apple, Sophia K" uniqKey="Apple S" first="Sophia K" last="Apple">Sophia K. Apple</name>
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<wicri:regionArea>Department of Pathology, UCLA Medical Center, Santa Monica, CA</wicri:regionArea>
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<author><name sortKey="Badve, Sunil" sort="Badve, Sunil" uniqKey="Badve S" first="Sunil" last="Badve">Sunil Badve</name>
<affiliation wicri:level="1"><nlm:affiliation>Departments of Pathology and Internal Medicine, Clarian Pathology Laboratory of Indiana University, Indianapolis, IN, USA.</nlm:affiliation>
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<author><name sortKey="Bleiweiss, Ira J" sort="Bleiweiss, Ira J" uniqKey="Bleiweiss I" first="Ira J" last="Bleiweiss">Ira J. Bleiweiss</name>
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<author><name sortKey="Brogi, Edi" sort="Brogi, Edi" uniqKey="Brogi E" first="Edi" last="Brogi">Edi Brogi</name>
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<author><name sortKey="Calvo, Jose P" sort="Calvo, Jose P" uniqKey="Calvo J" first="José P" last="Calvo">José P. Calvo</name>
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<country xml:lang="fr">Espagne</country>
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<author><name sortKey="Dabbs, David J" sort="Dabbs, David J" uniqKey="Dabbs D" first="David J" last="Dabbs">David J. Dabbs</name>
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<author><name sortKey="Ellis, Ian O" sort="Ellis, Ian O" uniqKey="Ellis I" first="Ian O" last="Ellis">Ian O. Ellis</name>
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<author><name sortKey="Eusebi, Vincenzo" sort="Eusebi, Vincenzo" uniqKey="Eusebi V" first="Vincenzo" last="Eusebi">Vincenzo Eusebi</name>
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<author><name sortKey="Farshid, Gelareh" sort="Farshid, Gelareh" uniqKey="Farshid G" first="Gelareh" last="Farshid">Gelareh Farshid</name>
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<author><name sortKey="Fox, Stephen B" sort="Fox, Stephen B" uniqKey="Fox S" first="Stephen B" last="Fox">Stephen B. Fox</name>
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<author><name sortKey="Ichihara, Shu" sort="Ichihara, Shu" uniqKey="Ichihara S" first="Shu" last="Ichihara">Shu Ichihara</name>
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<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Pathology, Nagoya Medical Center, Nagoya</wicri:regionArea>
</affiliation>
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<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:affiliation>School of Medicine and Pathology Queensland, The Royal Brisbane & Women's Hospital, University of Queensland Centre for Clinical Research, Brisbane, Qld, Australia.</nlm:affiliation>
<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>
</affiliation>
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<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:affiliation>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham</wicri:regionArea>
</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="1"><nlm:affiliation>Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY</wicri:regionArea>
</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="1"><nlm:affiliation>Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.</nlm:affiliation>
<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>
</affiliation>
</author>
<author><name sortKey="Sahin, Aysegul" sort="Sahin, Aysegul" uniqKey="Sahin A" first="Aysegul" last="Sahin">Aysegul Sahin</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Pathology, Division of Pathology/Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.</nlm:affiliation>
<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>
</affiliation>
</author>
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<affiliation wicri:level="1"><nlm:affiliation>Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.</nlm:affiliation>
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<wicri:regionArea>Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL</wicri:regionArea>
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<author><name sortKey="Soares, Fernando A" sort="Soares, Fernando A" uniqKey="Soares F" first="Fernando A" last="Soares">Fernando A. Soares</name>
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<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Department of Anatomic Pathology, A. C. Camargo Cancer Centre, São Paulo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Tse, Gary M" sort="Tse, Gary M" uniqKey="Tse G" first="Gary M" last="Tse">Gary M. Tse</name>
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<country xml:lang="fr">France</country>
<wicri:regionArea>Pôle Pathologie-Génétique-Immunologie, Institut Curie, Paris</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Tan, Puay Hoon" sort="Tan, Puay Hoon" uniqKey="Tan P" first="Puay Hoon" last="Tan">Puay Hoon Tan</name>
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<series><title level="j">Histopathology</title>
<idno type="eISSN">1365-2559</idno>
<imprint><date when="2016" type="published">2016</date>
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<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>
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<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>
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<front><div type="abstract" xml:lang="en">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.</div>
</front>
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<DateCreated><Year>2016</Year>
<Month>01</Month>
<Day>15</Day>
</DateCreated>
<DateCompleted><Year>2016</Year>
<Month>10</Month>
<Day>20</Day>
</DateCompleted>
<DateRevised><Year>2017</Year>
<Month>06</Month>
<Day>01</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1365-2559</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>68</Volume>
<Issue>1</Issue>
<PubDate><Year>2016</Year>
<Month>Jan</Month>
</PubDate>
</JournalIssue>
<Title>Histopathology</Title>
<ISOAbbreviation>Histopathology</ISOAbbreviation>
</Journal>
<ArticleTitle>Phyllodes tumours of the breast: a consensus review.</ArticleTitle>
<Pagination><MedlinePgn>5-21</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1111/his.12876</ELocationID>
<Abstract><AbstractText>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.</AbstractText>
<CopyrightInformation>© 2015 John Wiley & Sons Ltd.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tan</LastName>
<ForeName>Benjamin Y</ForeName>
<Initials>BY</Initials>
<AffiliationInfo><Affiliation>Department of Pathology, Singapore General Hospital, Singapore.</Affiliation>
</AffiliationInfo>
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<Initials>G</Initials>
<AffiliationInfo><Affiliation>Women's Pathology Consultants, Ruffolo Hooper & Associates, Tampa, FL, USA.</Affiliation>
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<Initials>SK</Initials>
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<Initials>S</Initials>
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<AffiliationInfo><Affiliation>Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.</Affiliation>
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<ForeName>José P</ForeName>
<Initials>JP</Initials>
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<Initials>DJ</Initials>
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<Initials>IO</Initials>
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</AffiliationInfo>
</Author>
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<Initials>V</Initials>
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<Initials>G</Initials>
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</AffiliationInfo>
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<ForeName>Stephen B</ForeName>
<Initials>SB</Initials>
<AffiliationInfo><Affiliation>Pathology Department, Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Vic., Australia.</Affiliation>
</AffiliationInfo>
</Author>
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<ForeName>Shu</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Pathology, Nagoya Medical Center, Nagoya, Japan.</Affiliation>
</AffiliationInfo>
</Author>
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<ForeName>Sunil R</ForeName>
<Initials>SR</Initials>
<AffiliationInfo><Affiliation>School of Medicine and Pathology Queensland, The Royal Brisbane & Women's Hospital, University of Queensland Centre for Clinical Research, Brisbane, Qld, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rakha</LastName>
<ForeName>Emad A</ForeName>
<Initials>EA</Initials>
<AffiliationInfo><Affiliation>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Reis-Filho</LastName>
<ForeName>Jorge S</ForeName>
<Initials>JS</Initials>
<AffiliationInfo><Affiliation>Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Richardson</LastName>
<ForeName>Andrea L</ForeName>
<Initials>AL</Initials>
<AffiliationInfo><Affiliation>Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sahin</LastName>
<ForeName>Aysegul</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Pathology, Division of Pathology/Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Schmitt</LastName>
<ForeName>Fernando C</ForeName>
<Initials>FC</Initials>
<AffiliationInfo><Affiliation>Laboratoire national de santé, Luxembourg city, Luxembourg.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Schnitt</LastName>
<ForeName>Stuart J</ForeName>
<Initials>SJ</Initials>
<AffiliationInfo><Affiliation>Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Siziopikou</LastName>
<ForeName>Kalliopi P</ForeName>
<Initials>KP</Initials>
<AffiliationInfo><Affiliation>Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Soares</LastName>
<ForeName>Fernando A</ForeName>
<Initials>FA</Initials>
<AffiliationInfo><Affiliation>Department of Anatomic Pathology, A. C. Camargo Cancer Centre, São Paulo, Brazil.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tse</LastName>
<ForeName>Gary M</ForeName>
<Initials>GM</Initials>
<AffiliationInfo><Affiliation>Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Vincent-Salomon</LastName>
<ForeName>Anne</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Pôle Pathologie-Génétique-Immunologie, Institut Curie, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tan</LastName>
<ForeName>Puay Hoon</ForeName>
<Initials>PH</Initials>
<AffiliationInfo><Affiliation>Department of Pathology, Singapore General Hospital, Singapore.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y"><Grant><GrantID>P30 CA008748</GrantID>
<Acronym>CA</Acronym>
<Agency>NCI NIH HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant><GrantID>P30 CA060553</GrantID>
<Acronym>CA</Acronym>
<Agency>NCI NIH HHS</Agency>
<Country>United States</Country>
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<MeshHeading><DescriptorName UI="D003937" MajorTopicYN="N">Diagnosis, Differential</DescriptorName>
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<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
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<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
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<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
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<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
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<Keyword MajorTopicYN="N">fibroadenoma</Keyword>
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<Keyword MajorTopicYN="N">metastasis</Keyword>
<Keyword MajorTopicYN="N">phyllodes</Keyword>
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<CoiStatement>The authors declare no conflicts of interest with respect to the authorship, research and/or publication of this article</CoiStatement>
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