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Published on: May 26, 2023
791
Management of Stromal Lesions
1333 City Boulevard West, Suite 700, Orange, CA 92868, USA.
The Surgical Clinics of North America
|November 6, 2022
Summary
Breast stromal lesions like fibroadenomas are usually benign. Phyllodes tumors, however, range from benign to malignant, requiring different surgical margins and potentially clinical trials for malignant cases.
Area of Science:
- Oncology
- Surgical Pathology
- Breast Surgery
Background:
- Breast stromal lesions encompass a spectrum of conditions, including fibroadenomas, phyllodes tumors, pseudoangiomatous stromal hyperplasia, periductal stromal tumors, and lipomas.
- The majority of these lesions are benign and managed conservatively through observation or surgical excision.
Purpose of the Study:
- To differentiate the management strategies for various breast stromal lesions.
- To highlight the distinct clinical behavior and treatment implications of phyllodes tumors based on their classification (benign, borderline, malignant).
Main Methods:
- Review of pathological classifications of common breast stromal lesions.
- Analysis of surgical management guidelines based on tumor type and grade.
- Discussion of prognostic factors and treatment recommendations for phyllodes tumors.
Main Results:
- Benign phyllodes tumors can be excised with clear margins.
- Borderline and malignant phyllodes tumors necessitate wide surgical excision with margins exceeding 1 cm.
- Malignant phyllodes tumors are associated with a poor prognosis.
Conclusions:
- Accurate pathological subcategorization of phyllodes tumors is critical for appropriate surgical management.
- Multidisciplinary discussion and consideration of clinical trials are recommended for malignant phyllodes tumors due to their poor prognosis.
