Purpose: Accurate classification of breast phyllodes tumors (PTs) on core biopsy can be challenging. The differential diagnosis of benign PT (BP) is fibroadenoma (FA), whereas the differential diagnosis of malignant PT (MP) is sarcomatoid (metaplastic) carcinoma (SC).
Methods: Here, we compare the pre-excision core biopsy diagnosis and clinicopathologic features of histologically confirmed MP, borderline PT (BLP), BP, FA, and SC. Consecutive cases of 34 histologically confirmed PT (14 MP, 10 BLP, 10 BP), 13 SC, and 10 FA were identified.
Results: A core biopsy diagnosis of SC was made only in SC (77%, p = 0.003). The diagnosis "malignant neoplasm" or "atypical spindle cell neoplasm" was made in 100% MP and 23% SC, but no other tumor (p = 0.0001). The diagnosis "phyllodes tumor" was made only in PT (44% BLP, 11% BP, p = 0.06). The diagnosis "fibroepithelial lesion" was made in 44% BLP, 67% BP, and 29% FA. The diagnosis "FA" was made most commonly in FA (57%) (versus 22% BP and no other tumor; p = 0.002). Neoadjuvant therapy was given only in SC (23%, p = 0.03); adjuvant therapy was given in 46% SC and 13% MP (p = 0.04).
Conclusions: A pre-operative core biopsy diagnosis of "malignant spindle cell neoplasm" separates MP and SC from BLP, BP, and FA. However, MP and SC can have overlapping features on core biopsy. Thus, one must be careful not to overcall SC on core biopsy, as patients diagnosed with SC may receive neoadjuvant therapy. A core biopsy diagnosis of "phyllodes tumor" is specific for PT and can guide treatment planning of a wide local excision.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s10549-019-05350-5 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Oxidised Apolipoprotein Peptidome Characterises Metabolic Dysfunction-Associated Steatotic Liver Disease.
Liver Int
February 2025
Roger Williams Institute of Liver Studies, Foundation for Liver Research, London, UK.
Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) encompasses a spectrum of histological conditions ranging from simple steatosis to fibrosing steatohepatitis, and is a risk factor for cardiovascular diseases (CVD). While oxidised apolipoproteins A and B have been linked to obesity and CVD, the association between other oxidised apolipoproteins and MASLD is yet to be established. To fill this gap, we characterised the circulating serum peptidome of patients with MASLD.
View Article and Find Full Text PDFCan PSMA PET detect intratumour heterogeneity in histological PSMA expression of primary prostate cancer? Analysis of [Ga]Ga-PSMA-11 and [F]PSMA-1007.
Eur J Nucl Med Mol Imaging
January 2025
Department of Radiation Oncology, University Medical Centre Freiburg, Robert-Koch Straße 3, 79106, Freiburg, Germany.
Purpose: Prostate-specific membrane-antigen positron emission tomography (PSMA PET) is a promising candidate for non-invasive characterization of prostate cancer (PCa). This study evaluated whether PET with tracers [Ga]Ga-PSMA-11 or [F]PSMA-1007 is capable to depict intratumour heterogeneity of histological PSMA expression.
Methods: Thirty-five patients with biopsy-proven primary PCa without evidence of metastatic disease nor prior interventions were prospectively enrolled.
Intratumoral Injection of mRNA-2752 and Pembrolizumab for High-Risk Ductal Carcinoma In Situ: A Phase 1 Nonrandomized Clinical Trial.
JAMA Oncol
January 2025
Department of Surgery, University of California, San Francisco.
Importance: Intratumoral immunotherapy that leverages the biological characteristics of high-risk ductal carcinoma in situ (DCIS) may be able to reduce the extent of surgical treatment and provide an alternative approach to improve patient outcomes.
Objective: To determine if combination intratumoral immunotherapy can activate immune cells to shrink or eliminate high-risk DCIS.
Design, Setting, And Participants: This phase 1 open-label nonrandomized clinical trial at a single academic center tested the safety and efficacy of intratumoral immunotherapy in patients with high-risk DCIS, defined as at least 2 of the following present: younger than 45 years, tumor size greater than 5 cm, high-grade, palpable mass, hormone receptor (HR)-negative, or ERBB2-positive.
F-DCFPyL PSMA-PET/CT Versus MRI: Identifying the Prostate Cancer Region Most at Risk of Radiation Therapy Recurrence for Tumor Dose Escalation.
Pract Radiat Oncol
December 2024
Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Quebec, Canada.
Purpose: Local recurrence of prostate cancer (PCa) after radiation therapy (RT) typically occurs at the site of dominant tumor burden, and recent evidence confirms that magnetic resonance imaging (MRI) guided tumor dose escalation improves outcomes. With the emergence of prostate-specific membrane antigen (PSMA) positron emission tomography (PET), we hypothesize that PSMA-PET and MRI may not equally depict the region most at risk of recurrence after RT.
Methods And Materials: Patients with intermediate- to high-risk PCa and MRI plus PSMA-PET performed before RT were identified.
MXene-based SERS spectroscopic analysis of exosomes for lung cancer differential diagnosis with deep learning.
Biomed Opt Express
January 2025
Key Laboratory of Optical Technology and Instrument for Medicine, Ministry of Education, University of Shanghai for Science and Technology, 200093 Shanghai, China.
Lung cancer with heterogeneity has a high mortality rate due to its late-stage detection and chemotherapy resistance. Liquid biopsy that discriminates tumor-related biomarkers in body fluids has emerged as an attractive technique for early-stage and accurate diagnosis. Exosomes, carrying membrane and cytosolic information from original tumor cells, impart themselves endogeneity and heterogeneity, which offer extensive and unique advantages in the field of liquid biopsy for cancer differential diagnosis.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!