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[Case #1. Grading of phyllode tumors: Practical insight and recommendations]
Léonie Alran1, Gaëtan Mac Grogan1
1Service d'anatomie et cytologie pathologique, institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France.
Annales De Pathologie
|May 28, 2025
Summary
Phyllodes tumors are rare malignant breast neoplasms. Current diagnostic criteria may not accurately predict metastatic recurrence risk, prompting research into new criteria.
Area of Science:
- Oncology
- Pathology
- Breast Cancer Research
Background:
- Phyllodes tumors are rare fibro-epithelial breast neoplasms, with most being benign.
- Malignant phyllodes tumors have specific diagnostic criteria outlined in the 2019 WHO classification.
- Metastatic recurrence occurs in 16% of malignant cases, typically involving the stromal component.
Purpose of the Study:
- To evaluate the diagnostic criteria for malignant phyllodes tumors.
- To assess the reliability of current criteria in predicting metastatic recurrence.
- To explore potential new diagnostic criteria for improved risk stratification.
Main Methods:
- Review of the 2019 WHO classification criteria for malignant phyllodes tumors.
- Analysis of reported features associated with distant metastases.
- Examination of recent studies proposing alternative diagnostic criteria.
Main Results:
- Malignant phyllodes tumors require specific features like stromal overgrowth and high mitotic index for diagnosis.
- Current WHO criteria may not reliably predict metastatic risk, especially the simultaneous presence of all adverse features.
- Recent studies suggest alternative criteria, but require further validation.
Conclusions:
- The 2019 WHO classification provides diagnostic criteria for malignant phyllodes tumors.
- There is a need to re-evaluate current grading systems for predicting metastatic potential.
- Prospective studies are necessary to validate novel diagnostic criteria for phyllodes tumors.
