How are Phyllodes Tumors Diagnosed?
By Jonas Wilson, Ing. Med.
Phyllodes tumors (PTs) are fibroepithelial tumors of the breast, which are rare and present clinically as painless lumps. They are primarily found in women between the fourth and sixth decades of life with a peak incidence at the age of 45. Occurrence in men is extremely rare, but has been reported in cases associated especially with enlargement of the male breast due to hormonal imbalances.
The rarity of PTs makes them difficult to diagnose by doctors who do not encounter them often. This difficulty is compounded by PTs having similar characteristics to fibroadenomas. Fibroadenomas are being breast tumors that consist of normal breast tissue and are frequently seen in younger …show more content…
These may be done by core needle, where samples are taken from the tumor via a special needle or the biopsies may be done as excisional procedures, where the entire tumor is removed. The latter is believed to be better by some experts, since small samples taken may not be adequate to confirm PTs.
Microscopic examination of PTs may lead to them being classified as malignant, borderline or benign. Malignant tumors have poorly defined edges with abnormally shaped stromal cells that are rapidly dividing. Epithelial cells (i.e. cells that line the lobules and ducts) may or may not be seen. In contrast, benign PTs tend to have well-defined edges with cells that are not dividing as rapidly. Their stromal cells have an almost normal appearance and epithelial cells are present. Borderline PTs, as one would expect, tend to fall in a grey zone between benign and malignant PTs.
On a macroscopic basis, PTs that are small tend to have a lobulated surface with uniformly white consistency. They are fairly similar in appearance to fibroadenomas. Cutting these tumors on section reveals a hemorrhagic and fibro-gelatinous consistency with areas of cell death and characteristic “leaf-like” protrusions into cystic spaces. This “leaf-like” appearance is the origin of the name phyllodes, which means “leaf-like” in Greek
By Jonas Wilson, Ing. Med.
Phyllodes tumors (PTs) are fibroepithelial tumors of the breast, which are rare and present clinically as painless lumps. They are primarily found in women between the fourth and sixth decades of life with a peak incidence at the age of 45. Occurrence in men is extremely rare, but has been reported in cases associated especially with enlargement of the male breast due to hormonal imbalances.
The rarity of PTs makes them difficult to diagnose by doctors who do not encounter them often. This difficulty is compounded by PTs having similar characteristics to fibroadenomas. Fibroadenomas are being breast tumors that consist of normal breast tissue and are frequently seen in younger …show more content…
These may be done by core needle, where samples are taken from the tumor via a special needle or the biopsies may be done as excisional procedures, where the entire tumor is removed. The latter is believed to be better by some experts, since small samples taken may not be adequate to confirm PTs.
Microscopic examination of PTs may lead to them being classified as malignant, borderline or benign. Malignant tumors have poorly defined edges with abnormally shaped stromal cells that are rapidly dividing. Epithelial cells (i.e. cells that line the lobules and ducts) may or may not be seen. In contrast, benign PTs tend to have well-defined edges with cells that are not dividing as rapidly. Their stromal cells have an almost normal appearance and epithelial cells are present. Borderline PTs, as one would expect, tend to fall in a grey zone between benign and malignant PTs.
On a macroscopic basis, PTs that are small tend to have a lobulated surface with uniformly white consistency. They are fairly similar in appearance to fibroadenomas. Cutting these tumors on section reveals a hemorrhagic and fibro-gelatinous consistency with areas of cell death and characteristic “leaf-like” protrusions into cystic spaces. This “leaf-like” appearance is the origin of the name phyllodes, which means “leaf-like” in Greek