Gemci Öykü Dila, Altınay Serdar, İlbar Tartar Rümeysa, Ferahman Sina
Department of Pathology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, İstanbul, Turkey.
Department of Molecular Oncology, Institute of Health Sciences, University of Health Sciences, İstanbul, Turkey.
Eur J Breast Health. 2022 Oct 1;18(4):343-352. doi: 10.4274/ejbh.galenos.2022.2022-6-2. eCollection 2022 Oct.
Phyllodes tumors (PTs) are a rare group of breast tumors. Most malignant transformations are carcinomas that are extremely rare and are limited to individual cases in the literature. The presence of /invasive carcinomas is important as this may alter clinical judgment and management. In this study, we aimed to determine the association of /invasive carcinomas among PTs.
This retrospectively designed study included cases diagnosed with PTs between 2011 and 2020 in the pathology department of a tertiary level hospital. Tumors were grouped into benign, borderline and malignant, according to stromal overgrowth, stromal atypia, stromal cellularity and mitotic activity. In addition, age, location, type of operation, tumor diameter, and surgical margin information were recorded. and/or invasive carcinoma foci accompanying the PTs were assessed.
A total of 29 patients diagnosed with PTs were identified, among whom 14 (48.2%) had benign PTs, 10 (34.4%) had borderline PTs, and 5 (17.2%) had malignant PTs. Of the patients with PTs, 3 (10.3%) had coexistent invasive carcinoma and 1 (3.4%) had carcinoma . In this cohort the incidence of coexistence of PT and carcinoma was 4/29 (13.7%), which is much higher than previously reported (1.1% and 6%). The incidence of carcinoma was 2/5 (40%) in malignant PT patients and 2/10 (20%) in borderline PT patients. The coexistence of malignant PTs and carcinoma was significantly higher than those of benign and borderline PTs (<0.05).
The multidisciplinary team dealing with breast diseases has a great responsibility in both diagnosis and treatment. We anticipate that these rates will increase with an increase in the awareness and importance of this coexistence of carcinoma and PTs.
叶状肿瘤(PTs)是一组罕见的乳腺肿瘤。大多数恶性转化为癌,极为罕见,在文献中仅限于个别病例。浸润性癌的存在很重要,因为这可能会改变临床判断和治疗方案。在本研究中,我们旨在确定PTs中浸润性癌之间的关联。
本项回顾性研究纳入了2011年至2020年在一家三级医院病理科诊断为PTs的病例。根据间质过度生长、间质异型性、间质细胞密度和有丝分裂活性,将肿瘤分为良性、交界性和恶性。此外,记录年龄、位置、手术类型、肿瘤直径和手术切缘信息。对PTs伴有的和/或浸润性癌灶进行评估。
共确定29例诊断为PTs的患者,其中14例(48.2%)为良性PTs,10例(34.4%)为交界性PTs,5例(17.2%)为恶性PTs。在PTs患者中,3例(10.3%)并存浸润性癌,1例(3.4%)有癌。在该队列中,PT与癌并存的发生率为4/29(13.7%),远高于先前报道的(1.1%和6%)。恶性PT患者中癌的发生率为2/5(40%),交界性PT患者中为2/10(20%)。恶性PTs与癌并存的情况显著高于良性和交界性PTs(<0.05)。
处理乳腺疾病的多学科团队在诊断和治疗方面都负有重大责任。我们预计,随着对癌与PTs并存情况的认识提高及其重要性的增加,这些发生率将会上升。