Recurrent cystosarcoma phyllodes.A clinicopathologic study of 32 cases

Hajdu, Steven I.; Espinosa, Manuel H.; Robbins, Guy F.

doi:10.1002/1097-0142(197609)38:3<1402::aid-cncr2820380346>3.0.co;2-9

Cited by 114 publications

(81 citation statements)

References 5 publications

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“…However, some can also exhibit a malignant clinical behavior with local recurrences and distant metastatic spread. 2 The histologic characteristics of the stroma determine whether a tumor is classified as benign or malignant. 3,4 The spectrum of stromal morphologies is very broad, from obviously benign with only moderately cellular stroma lacking atypia and mitoses; to frankly malignant with highly cellular stroma rich in mitoses and heterologous differentiation, as seen in other soft tissue sarcomas.…”

mentioning

confidence: 99%

Amplifications of the epidermal growth factor receptor gene (egfr) are common in phyllodes tumors of the breast and are associated with tumor progression

Kersting

Kuijper

Schmidt

et al. 2006

Laboratory Investigation

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Phyllodes tumors of the breast are rare biphasic tumors with the potential for invasion and metastatic spread. An important role of the epidermal growth factor receptor (EGFR) in phyllodes tumors has been proposed. However, detailed pathogenetic mechanisms remained unclear. We investigated 58 phyllodes tumors of the breast (40 benign, 10 borderline and eight malignant) by means of egfr fluorescence in situ hybridization (FISH) and gene dosage PCR for a regulatory sequence within intron 1 of egfr. Immunohistochemical staining was performed for EGFR, p16, p21, p27, p53, c-myc, Cyclin A, Cyclin D1, Cyclin E, c-kit and Ki67. Immunopositivity for EGFR was detected in 19% of phyllodes tumors (75% of all malignant tumors) in stromal tumor cells but not in the epithelial component. Whole-gene amplifications were seen by FISH in 15.8% (in stromal cells only) and intron 1 amplifications by gene dosage PCR in as much as 41.8% of all phyllodes tumors. Significant correlations were seen between tumor grade on the one hand and EGFR overexpression (P ¼ 0.001) and intron 1 amplifications (Po0.05) on the other. EGFR overexpression further correlated positively with immunohistochemical staining for p53, p16, Cyclin A, Cyclin E, Ki67 and c-kit. Presence of intron 1 amplifications correlated with p16 (Po0.01), p21 (P ¼ 0.009) and p53 immunoreactivity (Po0.001). Neither EGFR overexpression nor whole-gene amplification was observed in a control series of 167 fibroadenomas and only one of 43 (2.3%) exhibited intron 1 amplification in gene dosage PCR. In conclusion, our results show for the first time that activating mutations in and overexpression of egfr are associated with the progression in grade of phyllodes tumors of the breast. The observed association between intron 1 amplification and overexpression of EGFR provides further insight into regulation mechanisms of EGFR overexpression.

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mentioning

confidence: 99%

Amplifications of the epidermal growth factor receptor gene (egfr) are common in phyllodes tumors of the breast and are associated with tumor progression

Kersting

Kuijper

Schmidt

et al. 2006

Laboratory Investigation

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“…[25,47] Whether LR is a predictor for the development of systemic metastasis remains a controversial issue. Some authors have shown that up to 60% of patients with systemic metastasis develop prior LR, [25,[48][49][50] while some others refute this association. [10,11,23] LR or factors affecting LR may adversely affect survival for PT as well, similar to breast cancer.…”

Section: Histological Classificationmentioning

confidence: 67%

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

Wadasadawala¹,

Swain²,

Bajpai³

2016

Oncobiology and Targets

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Phyllodes tumor, previously known as cystosarcoma phyllodes, is a rare fibro-epithelial tumor of breast constituting <1% of all the breast tumors. It is classified into benign, borderline, and malignant subtypes depending upon the histological criteria defined by the World Health Organization and also has an independent prognostic significance. Accurate pretreatment histological diagnosis is important for the optimal management of phyllodes tumor so that low recurrence rates, improved survival, and optimal long-term cosmetic result can be achieved. Despite surgery being the standard of care, the best type of surgery for each histological type is yet to be defined. The higher rate of local recurrence after surgery alone in borderline and malignant phyllodes tumor raises the question regarding the need of adjuvant treatment, especially radiotherapy, which remains underutilized. The perspective of the current review is to provide the state-of-the-art management of phyllodes tumor of the breast and highlight the risk factors associated with recurrence.

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“…Table 34-4 summarizes collected series of CSPs in the literature with observed rates of local recurrence following excision. [92][93][94][95][96][97][98] The local recurrence rate is quite variable, partly owing to differences in extent of surgical resection undertaken. The cornerstone of the surgical approach to CSP is wide local excision with histologically negative margins.…”

Section: What Are the Treatment And Prognosis Of Cystosarcoma Phyllodes?mentioning

confidence: 99%