Alkushi Abdulmohsen, Arabi Haitham, Al-Riyees Lolwah, Aldakheel Abdulelah M, Al Zarah Raed, Alhussein Faisal, Altamimi Abdullah Mohammed, Alsulaiman Yazeed Abdulsalam, Omair Ahmad
Dept. of Pathology, King Abdulaziz Medical City of National Guard, Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Dept. of Pathology, King Abdulaziz Medical City of National Guard, Riyadh, Saudi Arabia.
Ann Diagn Pathol. 2021 Apr;51:151702. doi: 10.1016/j.anndiagpath.2021.151702. Epub 2021 Jan 12.
Phyllodes tumor (PT) accounts for <1% of all breast tumors worldwide. Based on their microscopic features, these tumors are classified into benign, borderline, and malignant. This study aimed at evaluating the clinical experience and the clinicopathologic features of PT.
A retrospective cohort study of 46 female patients with histologically diagnosed PT. Data collection and evaluation was done on patient demographics, preoperative radiological assessment and pathology, surgical procedure, post-surgery pathological evaluation, radiation therapy (RT), and follow-up.
The median age at diagnosis was 42 years and young premenopausal patients (median age 35 years) had malignant PT. Forty-five patients underwent core needle biopsy (CNB) with high sensitivity and the positive predictive value (82.2% and 97.4% respectively). Thirty-nine patients (86.7%) underwent conservative surgery and 6 (13.3%) had a mastectomy. Twenty-seven (58.6%) were classified as benign, 11 (23.9%) as borderline and only 8 (17.4%) as malignant PT. Malignant PT had the greatest median tumor size (13 cm). Mortality and recurrence rates were 4.3% and 2.2% respectively. RT was administered in 6 patients (13.0%), 5 having malignant and 1 borderline PT. The metastatic rate was found to be 6.5%.
PT are rare breast tumors with variable biologic behavior and heterogenous clinicopathological findings. Young, premenopausal women with large tumors may have malignant PT with a risk of recurrence and metastasis. Core needle biopsy is a reliable tool for diagnosis of PT with strict follow-up recommended for large tumors diagnosed as fibroadenoma on CNB. Surgical management must ensure a tumor-free margin on excision to reduce recurrence.
叶状肿瘤（PT）在全球所有乳腺肿瘤中占比不到1%。根据其微观特征，这些肿瘤可分为良性、交界性和恶性。本研究旨在评估叶状肿瘤的临床经验及临床病理特征。
对46例经组织学诊断为叶状肿瘤的女性患者进行回顾性队列研究。收集并评估患者的人口统计学数据、术前影像学评估及病理、手术过程、术后病理评估、放射治疗（RT）和随访情况。
诊断时的中位年龄为42岁，年轻的绝经前患者（中位年龄35岁）患有恶性叶状肿瘤。45例患者接受了粗针穿刺活检（CNB），其敏感性和阳性预测值较高（分别为82.2%和97.4%）。39例患者（86.7%）接受了保乳手术，6例（13.3%）进行了乳房切除术。27例（58.6%）被分类为良性，11例（23.9%）为交界性，只有8例（17.4%）为恶性叶状肿瘤。恶性叶状肿瘤的中位肿瘤大小最大（13厘米）。死亡率和复发率分别为4.3%和2.2%。6例患者（13.0%）接受了放疗，其中5例为恶性叶状肿瘤，1例为交界性叶状肿瘤。转移率为6.
