Phyllodes tumours of the breast: A consensus review

Benjamin Y. Tan, Geza Acs, Sophia K. Apple, Sunil Badve, Ira J. Bleiweiss, Edi Brogi, José P. Calvo, David J. Dabbs, Ian O. Ellis, Vincenzo Eusebi, Gelareh Farshid, Stephen B. Fox, Shu Ichihara, Sunil R. Lakhani, Emad A. Rakha, Jorge S. Reis-Filho, Andrea L. Richardson, Aysegul Sahin, Fernando C. Schmitt, Stuart J. SchnittKalliopi P. Siziopikou, Fernando A. Soares, Gary M. Tse, Anne Vincent-Salomon, Puay Hoon Tan

Research output: Contribution to journalReview articlepeer-review

134 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)5-21
Number of pages17
JournalHistopathology
Volume68
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Classification
  • Fibroadenoma
  • Malignant
  • Metastasis
  • Phyllodes

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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