Phyllodes tumor of the breast: Wolf inside the sheep’s skin!

Wadasadawala, Tabassum; Swain, Monali; Bajpai, Jaya

doi:10.18639/onbt.2016.03.1257

Cited by 2 publications

(2 citation statements)

References 42 publications

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“…In our case, the situation of the apparent mammary abscess misled doctors and surgical drainage was performed. However, in presence of a defined lump in the left breast, a US-guided core biopsy is the appropriate approach to reveal the presence of a biphasic lesion [ 20 ]. With that result, a surgical excision of the entire lump and a small normal tissue margin instead of a surgical drainage with an open biopsy of the mass is recommended [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Inflamed Phylloides Tumour in a Girl: A Challenging Diagnosis in Paediatric Breast Lesions

Testa

Salvatori

Prestipino

et al. 2018

IJERPH

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Introduction: Phylloides tumours (PTs) are rare fibroepithelial neoplasms that account for 0.3–0.9% of all breast tumours. These tumours typically occur in women aged 30–70 years. The occurrence of these tumours in older children and adolescents poses particular diagnostic and therapeutic problems. However, early diagnosis is mandatory because although most of the cases of PTs in children are benign, the borderline and malignant cases with potential negative outcomes cannot be excluded. Case presentation: A 12-year-old girl presented at the Paediatric Emergency Department for hyperaemia and warmth of the left breast that occurred a few days prior without fever. The girl experienced menarche 8 months previously. She experienced no previous trauma and she had no family history of breast cancer. On physical examination, the left breast was painful, enlarged and tender. The overlying skin was erythematous and warm. A breast ultrasonography (US) revealed a large mass with features of an abscess, including a hyperechoic wall, scattered internal echoes and hypoechoic peripheral lacunae of apparent colliquative nature. After 4 days of unsuccessful antibiotic therapy, surgical drainage was performed due to the suspicion of a mammary abscess. At the surgical incision site, the lesion was not-well circumscribed and lacked a capsule. In addition, purulent material was not detected. Histological examination revealed that the tissue alterations were compatible with benign PT. With this diagnosis, the girl underwent definitive surgical removal of the lesion. The postoperative period passed without negative events. An US performed 6 months later revealed that no new mass was present at this time, suggesting no recurrence of the tumour. Conclusion: This case shows that in the presence of a clinical picture suggesting the inflammation of the breast in adolescent females, PT should be considered as a possible diagnosis and US-guided core biopsy should be considered to confirm this suspicion. Thereafter, when surgical excision is performed, particular attention must be paid to both the preservation of all the normal breast parenchyma and future aesthetic problems.

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Section: Discussionmentioning

confidence: 99%

Inflamed Phylloides Tumour in a Girl: A Challenging Diagnosis in Paediatric Breast Lesions

Testa

Salvatori

Prestipino

et al. 2018

IJERPH

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“…3 Additionally, data from the Korean group also suggested that there was no survival benefit over 7 years with IMLN-RT. 8 9 With no evidence of overall survival benefit and toxicity concerns (pulmonary and cardiac fibrosis), the adoption of pIMLN-RT in routine clinical practice has been variable. Newer techniques of therapeutic RT with three-dimensional conformal radiotherapy (3DCRT), intensity-modulated RT (IMRT), volume modulated arc therapy (VMAT), and proton therapy compared to the conventional two-dimensional technique have partially abrogated the concerns of toxicity.…”

Section: Introductionmentioning

confidence: 99%

A Questionnaire Survey of Current Practice in the Management of Internal Mammary Lymph Nodes in Breast Cancer

Rao

Nair

Wadasadawala

et al. 2023

South Asian J Cancer

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Background Radiotherapy (RT) is an important modality in the management of breast cancers (BC). Large randomized trials have suggested that prophylactic regional nodal irradiation inclusive of internal mammary lymph nodes (IMLN) reduces BC-related mortality. However, the adoption of IMLN-RT has been variable due to relative benefits and toxicity concerns. Methods A survey was emailed to radiation oncologists (ROs) across the country wherein they were asked about their practice regarding IMLN-RT in BC. Results We received 128 responses, which included radiation oncologists across both private institutions (PIs) and government institutions (GIs). Fifty-six (43.8%) routinely offer prophylactic(p) IMLN-RT and an additional 15 (11.71%) suggested they would have offered it in the absence of logistic constraints. Almost all, 121 (94.5%) radiate the IMLN in case of radiologically positive lymph nodes (LNs).Fifty-six ROs (43.8%) offered prophylactic IMLN-RT in node-negative disease. Among those who did not offer IMLN-RT, most (84.72%) felt the clinical evidence was equivocal. Of the 56 who offered pIMLN-RT, 34/56 (60.71%) offered to locally advanced tumors, 20/56 (35.71%) offered to all inner and central tumors (ICQT), 29/56 (51.78%) to > 4 axillary LN-positive and 9/56 (16.07%) to any axillary LN-positive. The majority, i.e., 36/56 (64.28%) radiated upper three intercostal spaces, 9 (16.07%) radiated upper five intercostal spaces, and 6 (10.9%) decided based on tumor location, while 5 (9%) irradiated one space below the involved space.Overall, simulation-based planning was undertaken in 99% of PIs as opposed to 89% of GIs (p = 0.03). The majority of ROs, i.e., 92 (72.4%) preferred IMRT to IMLN-RT.In addition, the surgical approach to IMLN was practiced by surgeons at 18 (14%) centers, of which 13 (72.22%) operated the IMLN when radiologically evident. The IMLN dissection was preferentially performed for second and third intercostal spaces as suggested in 10 (55.55%) responses, while 8 (44.44%) performed thoracoscopic dissection of the IMLN chain. The distribution of prophylactic, definitive IMLN-RT, and IMLN dissection did not differ significantly between GI and PI (p = NS). Conclusions pIMLN-RT is still not the standard protocol in most centers citing equivocal evidence in the literature. Logistics, though different in GIs and PIs, did not impact the decision of pIMLN-RT. Further efforts would be required to standardize practice in IMLN across India.

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Phyllodes tumor of the breast: Wolf inside the sheep’s skin!

Cited by 2 publications

References 42 publications

Inflamed Phylloides Tumour in a Girl: A Challenging Diagnosis in Paediatric Breast Lesions

Inflamed Phylloides Tumour in a Girl: A Challenging Diagnosis in Paediatric Breast Lesions

A Questionnaire Survey of Current Practice in the Management of Internal Mammary Lymph Nodes in Breast Cancer

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