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Malignant Phyllodes Tumor: Imaging Features With Histopathologic Correlation.

Jane S Lee1, Jodie Chang2, Ian S Hagemann1

  • 1Washington University School of Medicine, Department of Pathology and Immunology, St. Louis, MO, USA.

Journal of Breast Imaging
|March 1, 2024
PubMed
Summary
This summary is machine-generated.

Phyllodes tumors (PT) are rare breast lesions. Malignant PT often present as large, irregular masses, requiring surgical excision and close monitoring for local recurrence, though survival rates remain high.

Keywords:
breastimagingpathologyphyllodes tumorreview

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Area of Science:

  • Oncology
  • Pathology
  • Radiology

Background:

  • Phyllodes tumors (PT) are rare fibroepithelial breast lesions.
  • They are classified as benign, borderline, or malignant based on histopathology.
  • Malignant PT often present as rapidly enlarging, palpable masses.

Purpose of the Study:

  • To review the clinical presentation, imaging, histopathology, and management of malignant Phyllodes tumors.
  • To highlight diagnostic challenges and treatment strategies for malignant PT.
  • To provide an overview of the prognosis and survival rates for malignant PT.

Main Methods:

  • Review of clinical presentation and imaging findings.
  • Histopathological analysis for classification and differential diagnosis.
  • Surgical management and adjuvant therapy considerations.

Main Results:

  • Malignant PT tend to be larger and more irregular than benign PT, often lacking circumscribed margins.
  • Distinguishing malignant PT from sarcomas and metaplastic carcinoma is crucial for prognosis.
  • Wide local excision is the primary treatment; adjuvant therapies have limited roles.
  • Local recurrence occurs in nearly one-third of malignant PT cases.
  • Distant metastasis is rare, with a 5-year survival rate near 80%.

Conclusions:

  • Malignant Phyllodes tumors require accurate diagnosis and surgical management.
  • Close follow-up is necessary due to the risk of local recurrence.
  • Despite challenges, the overall prognosis for malignant PT is relatively favorable.