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The Breast, Comprehensive Management of Benign and Malignant Diseases - malaimare.ro

Phyllodes tumors tend to grow quickly, but they rarely spread outside the breast.

The Breast, Comprehensive Management of Benign and Malignant Diseases - malaimare.ro

Inthe World Health Organization classified the phyllodes tumors into three subtypes benign, borderline and malignantaccording to benign cancer of breast clinicopathological characteristics, including the degree of stromal cell atypia and stromal overgrowth, tumor necrosis, the status of mitosis and the tumor margin.

In this paper we present a case of giant phyllodes tumor of the breast in a young woman, with its clinicopathological particularities and the different treatment options. Acestea au tendinţa de a creş­te ra­pid, diseminând foarte rar în afara sânului.

In urma ecografiei de san, a mamografiei si a rezonantei magnetice nucleare RMN — examinari imagistice necesare pentru depistarea afectiunilor benign cancer of breast - pe fisa cu rezultate apare si un cod BI-RADS Breast Imaging - Reporting and Database System, in traducere - Sistem de date si raportare in imagistica sanului. Acronimul este un protocol impus de Colegiul American de Radiologie si agreat ca standard in screeningul cancerului de san folosit de medicii imagisti din intreaga lume. Codul este un rezultat de la 0 la 6, acordat in functie de densitatea tesutului mamar, numarul indicand posibile grade de malignitate. Acest scor de risc devine baza tratamentului si a recomandarilor de investigatii ulterioare. Sunt necesare investigatii imagistice suplimentare pentru colectarea de mai multe informatii.

ÎnOr­ga­ni­za­­ţia Mondială a Sănătăţii a clasificat tumorile phyllodes în trei sub­ti­puri benigne, borderline şi maligneîn funcţie de di­fe­ri­tele ca­rac­teristici clinicopatologice, incluzând gradul de ati­pie celulară stromală, gradul de necroză tumorală, numărul mi­to­zelor şi prezenţa invaziei marginilor de rezecţie. În această lu­cra­re prezentăm cazul unei paciente tinere cu tumoră phyllodes, cu particularităţile clinicopatologice pe care le prezintă şi op­ţiunile diferite de tratament.

The name of the phyllodes tumor comes from the Greek word phullon meaning leaf. Phyllodes tumors are divided into three subtypes benigne, borderline and malignant ,   depending on the degree of the stromal cellular atypia, mitotic activity per 10 high-power fields, degree of stromal overgrowth these three are benign cancer of breast maintumor necrosis, and margin appearance.

Borderline tumors have the greatest tendency for local benign cancer of breast 2,3. All forms of phyllodes tumors have malignant potential and can behave like sarcomas, with metastases to various organs, commonly the lungs, bone and abdominal viscera 4.

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The only treatment option for these tumors is the surgical removal. Case report A year-old female presented to our department in Decemberwith a lump in the left breast that had been gradually increasing for three months.

In the last month before presenting benign cancer of breast the hospital, the tumoral mass had ulcerated and started to bleed.

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A biopsy showed a phyllodes tumor. The patient perfomed total mastectomy without axillary dissection. Figure 1. Large left breast mass on the benign cancer of breast examination Macroscopic findings A breast tissue measuring 20×18×13 cm in dimensions was resected Figure 2 and Figure 3. Deep margin displays sole smooth surfaced nodules, cut surface is multinodular and shows variable sized fleshy, soft to firm, off-white to ash colored leafy nodules.

Tumoră phyllodes gigantică

Figures 2 and 3. The extended area of the epidermis of the covering epidermis, plated with granular tissue with infiltrated polymorphic infiltration lymphocytes, numerous plasmocytes, rare polymorphonuclear neutrophils and eosinophils. The patient was evaluated gynecologically because of uterine changes that showed the presence of multiple uterine fibroids, and at the level of bone system, by bone scintigraphy, that did not show the presence of bone metastases.

Postoperatively, the initiation of adjuvant chemotherapy followed by chest irradiation was discussed. Inthe World Health Organization classified phyllodes tumors into three subtypes — benign, borderline and malignant —, according to various clinicopathological characteristics, including the degree of stromal cell atypia and stromal overgrowth, tumor necrosis, the benign cancer of breast of mitosis and the tumor margin Cancer limfatic stadiul 2, the histologic classification does not always predict the outcome.

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The therapeutic decision is difficult to take due to the lack of predictive factors. Different studies have shown that infiltration of resection margins, elevated mitosis rates, and rapid benign cancer of breast growth are important prognostic and predictive factors Not all patients with positive margins develop recurrence.

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KI67 is an important prognostic marker. Another tumor prognostic factor was considered the tumoral size, which was found to positively correlate with distant metastasis, and it was also observed that women with distant metastases tended to present with larger tumors Several authors found radiotherapy to reduce the local recurrence rates, but unlike with the usual invasive breast cancers, radiation did not improve the survival in malignant phyllodes Local recurrences still deve­loped in patients who received radiation, but few studies demonstrated that these women had large tumors and involved surgical margins, which rendered them at high risk of recurrence regardless.

Tan and colleagues developed a nomogram to predict recurrence-free survival, based on stromal atypia, mitoses, stromal overgrowth and surgical margins Even though the nomogram was not developed specifically for distant metastasis, it is likely still relevant, since recurrences are more often systemic, rather than isolated local recurrences, in malignant phyllodes. Conclusions Phyllodes tumors are a heterogeneous tumor group whose prognosis is difficult to define.

Giant phyllodes tumor of the breast

The prognosis depends on the histological and biological characteristics of the tumors. The only therapeutic method is the surgical treatment at present, and the complete resection with clear surgical margins appears to be the best predictor of a good survival. In case of phyllodes benign and borderline tumors, post-resection follow-up remains the method of choice, although adjuvant chemotherapy and radiotherapy are discussed in borderline tumors.

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Involved margins are associated with distant metastases, and the conventional chemotherapy and radiation treatments do benign cancer of breast appear effective. Conflict of interests: The authors declare no conflict of interests.

What percent of breast lumps are benign ? -Find Health Questions

Clinicopathologic risk factors for the local recurrence of phyllodes tumors of the breast. Ann Surg Oncol.

Specificații

Breast Cancer, Version 1. J Natl Compr Canc Netw. A rare case of breast malignant phyllodes tumor with metastases to the kidney: Case report. Medicine Baltimore.

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  • Tumoră phyllodes gigantică

Malignant phyllodes tumor of the breast: Treatment and prognosis. Breast J. Malignant phyllodes tumours of the breast. A clinical and pathological analysis of 55 cases.

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Eur J Cancer. Breast Cancer Res Treat.

Riscul de cancer de san:

Pathologic, immunohistochemical, and molecular features of benign and malignant phyllodes tumors of the breast. Mod Pathol. Altered expression of p53 and its regulated proteins in phyllodes tumours of the breast.

J Pathol. Malignant phyllodes tumours of the breast display increased stromal p53 protein expression.

REVIEW-URI

The clinical and histologic criteria that predict metastases from cystosarcoma phyllodes. August DA, Kearney T. Cystosarcoma phyllodes: mastectomy, lumpectomy, or lumpectomy plus irradiation. Surg Oncol.

[Phyllodes tumor. The experience of the 4th Obstetrics-Gynecology Department].

Utilization of radiotherapy for malignant phyllodes tumors: analysis of the National Cancer Data Base. Malignant phyllodes tumor of the breast: treatment and prognosis. Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins.

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