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Phyllodes tumours of the breast: a consensus review.

Identifieur interne : 002331 ( PubMed/Curation ); précédent : 002330; suivant : 002332

Phyllodes 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 :

RBID : pubmed:26768026

Descripteurs français

English descriptors

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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pubmed:26768026

Le document en format XML

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<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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<name sortKey="Siziopikou, Kalliopi P" sort="Siziopikou, Kalliopi P" uniqKey="Siziopikou K" first="Kalliopi P" last="Siziopikou">Kalliopi P. Siziopikou</name>
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<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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<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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<title xml:lang="en">Phyllodes tumours of the breast: a consensus review.</title>
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<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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<nlm:affiliation>Department of Pathology, Singapore General Hospital, Singapore.</nlm:affiliation>
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<name sortKey="Acs, Geza" sort="Acs, Geza" uniqKey="Acs G" first="Geza" last="Acs">Geza Acs</name>
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<nlm:affiliation>Women's Pathology Consultants, Ruffolo Hooper & Associates, Tampa, FL, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
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<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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<nlm:affiliation>Department of Pathology, UCLA Medical Center, Santa Monica, CA, USA.</nlm:affiliation>
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<name sortKey="Badve, Sunil" sort="Badve, Sunil" uniqKey="Badve S" first="Sunil" last="Badve">Sunil Badve</name>
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<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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<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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<nlm:affiliation>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.</nlm:affiliation>
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<name sortKey="Eusebi, Vincenzo" sort="Eusebi, Vincenzo" uniqKey="Eusebi V" first="Vincenzo" last="Eusebi">Vincenzo Eusebi</name>
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<name sortKey="Farshid, Gelareh" sort="Farshid, Gelareh" uniqKey="Farshid G" first="Gelareh" last="Farshid">Gelareh Farshid</name>
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<nlm:affiliation>BreastScreen SA, Discipline of Medicine, Adelaide University and Directorate of Surgical Pathology, SA Pathology, Adelaide, South Australia.</nlm:affiliation>
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<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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<nlm:affiliation>Pathology Department, Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Vic., Australia.</nlm:affiliation>
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<name sortKey="Ichihara, Shu" sort="Ichihara, Shu" uniqKey="Ichihara S" first="Shu" last="Ichihara">Shu Ichihara</name>
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<nlm:affiliation>Department of Pathology, Nagoya Medical Center, Nagoya, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Pathology, Nagoya Medical Center, Nagoya</wicri:regionArea>
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<name sortKey="Lakhani, Sunil R" sort="Lakhani, Sunil R" uniqKey="Lakhani S" first="Sunil R" last="Lakhani">Sunil R. Lakhani</name>
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<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>
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<name sortKey="Rakha, Emad A" sort="Rakha, Emad A" uniqKey="Rakha E" first="Emad A" last="Rakha">Emad A. Rakha</name>
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<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>
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<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>
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<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>
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<name sortKey="Richardson, Andrea L" sort="Richardson, Andrea L" uniqKey="Richardson A" first="Andrea L" last="Richardson">Andrea L. Richardson</name>
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<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>
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<author>
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<author>
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<name sortKey="Siziopikou, Kalliopi P" sort="Siziopikou, Kalliopi P" uniqKey="Siziopikou K" first="Kalliopi P" last="Siziopikou">Kalliopi P. Siziopikou</name>
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<nlm:affiliation>Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.</nlm:affiliation>
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<nlm:affiliation>Department of Anatomic Pathology, A. C. Camargo Cancer Centre, São Paulo, Brazil.</nlm:affiliation>
<country xml:lang="fr">Brésil</country>
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</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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<nlm:affiliation>Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.</nlm:affiliation>
<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>
</affiliation>
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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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<nlm:affiliation>Pôle Pathologie-Génétique-Immunologie, Institut Curie, Paris, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
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</affiliation>
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<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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<nlm:affiliation>Department of Pathology, Singapore General Hospital, Singapore.</nlm:affiliation>
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<title level="j">Histopathology</title>
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<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>
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<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>
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<term>Carcinomes</term>
<term>Fibroadénome</term>
<term>Région mammaire</term>
<term>Sarcomes</term>
<term>Tumeur phyllode</term>
<term>Tumeurs du sein</term>
</keywords>
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<term>Breast</term>
<term>Breast Neoplasms</term>
<term>Carcinoma</term>
<term>Fibroadenoma</term>
<term>Phyllodes Tumor</term>
<term>Sarcoma</term>
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<term>Consensus</term>
<term>Diagnosis, Differential</term>
<term>Female</term>
<term>Humans</term>
</keywords>
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<term>Consensus</term>
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<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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<Year>2016</Year>
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<Day>15</Day>
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<Year>2016</Year>
<Month>10</Month>
<Day>20</Day>
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<Year>2016</Year>
<Month>Jan</Month>
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<Title>Histopathology</Title>
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<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>
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<ForeName>Benjamin Y</ForeName>
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</AffiliationInfo>
</Author>
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<LastName>Acs</LastName>
<ForeName>Geza</ForeName>
<Initials>G</Initials>
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<Affiliation>Women's Pathology Consultants, Ruffolo Hooper & Associates, Tampa, FL, USA.</Affiliation>
</AffiliationInfo>
</Author>
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<ForeName>José P</ForeName>
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</AffiliationInfo>
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<LastName>Fox</LastName>
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<Affiliation>Pathology Department, Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Vic., Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Ichihara</LastName>
<ForeName>Shu</ForeName>
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<Affiliation>Department of Pathology, Nagoya Medical Center, Nagoya, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Lakhani</LastName>
<ForeName>Sunil R</ForeName>
<Initials>SR</Initials>
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<LastName>Rakha</LastName>
<ForeName>Emad A</ForeName>
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<Affiliation>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y">
<LastName>Reis-Filho</LastName>
<ForeName>Jorge S</ForeName>
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<AffiliationInfo>
<Affiliation>Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.</Affiliation>
</AffiliationInfo>
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<LastName>Richardson</LastName>
<ForeName>Andrea L</ForeName>
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<AffiliationInfo>
<Affiliation>Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y">
<LastName>Sahin</LastName>
<ForeName>Aysegul</ForeName>
<Initials>A</Initials>
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<Affiliation>Department of Pathology, Division of Pathology/Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.</Affiliation>
</AffiliationInfo>
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<LastName>Schmitt</LastName>
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<AffiliationInfo>
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</AffiliationInfo>
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<LastName>Schnitt</LastName>
<ForeName>Stuart J</ForeName>
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<AffiliationInfo>
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<Author ValidYN="Y">
<LastName>Siziopikou</LastName>
<ForeName>Kalliopi P</ForeName>
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<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>
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<AffiliationInfo>
<Affiliation>Department of Pathology, Singapore General Hospital, Singapore.</Affiliation>
</AffiliationInfo>
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