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Ja Seung Koo - One of the best experts on this subject based on the ideXlab platform.
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expression of caf related proteins is associated with histologic grade of breast Phyllodes Tumor
Disease Markers, 2016Co-Authors: Hye Min Kim, Yu Kyung Lee, Ja Seung KooAbstract:Purpose. The purpose of this study was to investigate the expression of cancer-associated fibroblast- (CAF-) related proteins and the implications in breast Phyllodes Tumor (PT). Methods. Tissue microarrays of 194 PT cases (151 benign PT, 27 borderline PT, and 16 malignant PT) were constructed. We performed immunohistochemical staining for CAF-related proteins (podoplanin, prolyl 4-hydroxylase, FAPα, S100A4, PDGFR α/β, and NG2) and analyzed the results according to clinicopathologic parameters. Results. Expression of PDGFRα and PDGFRβ in the stromal component increased with increasing histologic grade of PT ( and , resp.). Among clinicopathologic parameters, only expression of FAPα in stroma was associated with distant metastasis (). In univariate analysis, stromal expression of PDGFRα was associated with shorter overall survival (). In Cox multivariate analysis, stromal overgrowth and PDGFRα stromal positivity were associated with shorter overall survival ( and , resp.). Furthermore, expression of PDGFRβ in stroma was associated with shorter overall survival in patients with malignant PT (). Conclusion. Stromal expression of PDGFRα and PDGFRβ increased with increasing histologic grade of PT. In addition, PDGFR stromal positivity was associated with shorter overall survival. These results suggest that CAFs are associated with breast PT progression.
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analysis of Phyllodes Tumor recurrence according to the histologic grade
Breast Cancer Research and Treatment, 2013Co-Authors: Sewha Kim, Ji Ye Kim, Do Hee Kim, Woo Hee Jung, Ja Seung KooAbstract:Local recurrence of Phyllodes Tumor (PT) of the breast is an adverse outcome that can result in sarcomatous degeneration. The aim of this study was to investigate the histologic and surgical factors associated with local recurrence. A total of 193 PT cases were studied: 145 (75.1 %) benign cases, 33 (17.1 %) borderline cases, and 15 (7.8 %) malignant cases. Stratifying our analysis according to histologic grade, we investigated the relationship between disease-free survival (DFS) and both histologic and surgical factors, including histologic grade, stromal cellularity, stromal atypia, stromal mitosis, stromal overgrowth, Tumor margin, type of surgical procedure (local excision, wide excision, and mastectomy), surgical margin status, and radiation therapy. In the case of benign PT, all patients with local recurrences (3.4 %) had been treated with local excision, and all recurrent Tumors were also benign. The local recurrence rate for locally excised benign PTs was not associated with surgical margin status or radiation therapy. In the case of borderline PT, local excision was associated with an increased local recurrence rate (P = 0.046). In malignant PT, small Tumor size (≤4.0 cm) was associated with an increased local recurrence rate (P = 0.041). Univariate analyses indicated that surgical procedure (mastectomy < local excision < wide excision; P < 0.001) was significantly associated with shorter DFS in borderline PT. A positive surgical resection margin (P < 0.001) was associated with DFS in malignant PT. The factors associated with local recurrence differed with the histologic grade of PT, as did the features of local recurrence itself. In particular, benign PT had very low rate of local recurrence regardless of surgical margin status or radiation therapy, even when treated with local excision. In the case of benign PT, no recurrent Tumors had worse histologic grades than the initial Tumors.
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comparative study of histological features between core needle biopsy and surgical excision in Phyllodes Tumor
Pathology International, 2012Co-Authors: Junjeong Choi, Ja Seung KooAbstract:We analyzed histopathological features of core needle biopsy (CNB) and surgical excision specimen comparatively in 129 patients with surgically proven Phyllodes Tumor (PT). Stromal characteristics including cellularity, atypia, mitosis, overgrowth, tissue fragmentation, and the Tumor margin were assessed. Benign/borderline/malignant Phyllodes Tumor (PT) were diagnosed in 90 (69.8%)/30 (23.3%)/9 (7.0%) patients. Among the 90 cases of benign PTs, 67 cases (74.4%) were diagnosed concordantly in CNB. For borderline and malignant PTs, three out of eight (26.6%) and four out of nine (44.4%) cases were diagnosed concordantly in CNBs. All 50 cases of discordant diagnosis were underestimated in matched CNBs, especially in their stromal cellularity and mitosis. The size of Tumor is larger in discordant cases of PT (P= 0.013). The concordant rate of diagnosis between CNB and surgical excision was about 60% and accordingly, grading of PT based on the histological findings in CNBs has limitation. The discordance comes from heterogeneous stromal properties of PTs.
Sebastian Aulmann - One of the best experts on this subject based on the ideXlab platform.
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invasive ductal breast cancer within a malignant Phyllodes Tumor case report and assessment of clonality
Human Pathology, 2010Co-Authors: Stephan Machergoeppinger, Frederik Marme, Benjamin Goeppert, Roland Penzel, Peter Schirmacher, Hanspeter Sinn, Sebastian AulmannAbstract:Invasive carcinomas arising within fibroepithelial Tumors represent an uncommon manifestation of breast cancer. We report the case of a 70-year-old woman who underwent mastectomy for a malignant Phyllodes Tumor measuring 6 cm. Histological workup of the specimen revealed a high-grade invasive ductal carcinoma 2.5 cm in diameter within the Phyllodes Tumor. DNA was isolated from microdissected epithelial and stromal components of the Phyllodes Tumor as well as from the invasive ductal carcinoma cells. Using multiplex polymerase chain reaction, a comparative allelotyping was performed with a panel of 11 microsatellite markers. The malignant stroma of the Phyllodes Tumor showed loss of heterozygosity at chromosome 16q23, 17q12, 17q25, and 22q13; the epithelial Tumor component shared the loss of 16q23; whereas the invasive carcinoma had lost divergent alleles at 16q23, 17q12, and 17q25, indicating a lack of clonality between Phyllodes Tumor and invasive ductal carcinoma. Although our data are compatible with a previously postulated common origin of epithelial and stromal components of Phyllodes Tumors, the coexisting invasive ductal carcinoma appears to represent a true collision Tumor.
Takuji Iwase - One of the best experts on this subject based on the ideXlab platform.
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malignant transformation of breast fibroadenoma to malignant Phyllodes Tumor long term outcome of 36 malignant Phyllodes Tumors
Breast Cancer, 2011Co-Authors: Makoto Abe, Satoshi Miyata, Seiichiro Nishimura, Kotaro Iijima, Masujiro Makita, Futoshi Akiyama, Takuji IwaseAbstract:Malignant Phyllodes Tumor of the breast is a rare neoplasm for which clinical findings remain insufficient for determination of optimal management. We examined the clinical behavior of these lesions in an attempt to determine appropriate management. We evaluated long-term outcome and clinical characteristics of malignant Phyllodes Tumors arising from fibroadenomas of the breast. A total of 173 patients were given a diagnosis of Phyllodes Tumor and underwent surgery at the Cancer Institute Hospital in Japan between January 1980 and December 1999. Of these patients, 39 (22.5%) were given a diagnosis of malignant Phyllodes Tumor; in three of these cases, detailed medical records were lost. Malignant Phyllodes Tumors were classified into two groups based on history of malignant transformation. Of the 36 malignant cases, 11 (30.6%) were primary and were given a diagnosis of fibroadenoma, experienced recurrence during the follow-up period, and were diagnosed with malignant Phyllodes Tumor (cases with a history of fibroadenoma). The other group was defined as cases without history of fibroadenoma and in whom lesions initially occurred as malignant Phyllodes Tumors. Based on differences between the two groups, overall survival curves were plotted using the Kaplan–Meier method, and statistical comparisons were performed using the log-rank test and Peto and Peto’s test. The outcome of cases with history of fibroadenoma was significantly better than that of cases without history of fibroadenoma. Patients with malignant Phyllodes Tumors but without prior history of malignant transformation who exhibit rapid growth within 6 months require aggressive treatment.
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malignant transformation of breast fibroadenoma to malignant Phyllodes Tumor long term outcome of 36 malignant Phyllodes Tumors
Breast Cancer, 2011Co-Authors: Makoto Abe, Satoshi Miyata, Seiichiro Nishimura, Kotaro Iijima, Masujiro Makita, Futoshi Akiyama, Takuji IwaseAbstract:Background Malignant Phyllodes Tumor of the breast is a rare neoplasm for which clinical findings remain insufficient for determination of optimal management. We examined the clinical behavior of these lesions in an attempt to determine appropriate management. We evaluated long-term outcome and clinical characteristics of malignant Phyllodes Tumors arising from fibroadenomas of the breast.
Ana M Grau - One of the best experts on this subject based on the ideXlab platform.
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malignant Phyllodes Tumor of the breast review of the literature and case report of stromal overgrowth
Surgical Oncology-oxford, 2003Co-Authors: Marlon A Guerrero, Billy R Ballard, Ana M GrauAbstract:Abstract Cystosarcoma Phyllodes constitutes only 0.3–0.9% of all breast Tumors. The term "sarcoma" was initially used because of its fleshy appearance, a more modern term is Phyllodes Tumor (PT). The behavior of PT constitutes a spectrum from benign and locally recurrent to malignant and metastatic. In a general surgical series, 6.2% of the Tumors were malignant. The microscopic appearance of PT is that of epithelial elements and connective tissue stroma. Malignancy is determined by characteristics of the stroma. The metastatic spread of malignant PT is mainly hematogenous to lung, with infrequent lymphatic involvement. Wide local excision with 2cm margins is the treatment of choice. In 20% of both benign and malignant cases, PT will locally recur. There is no proven benefit of radiation or chemotherapy, although radiotherapy may be useful in selected cases. We present a case of a sarcomatous overgrowth in a malignant Phyllodes Tumor involving multiple histologic types.
Yutao Lei - One of the best experts on this subject based on the ideXlab platform.
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recurrent malignant Phyllodes Tumor of the breast a case report
Medicine, 2017Co-Authors: Qinqin Wang, Yutao LeiAbstract:Rationale Phyllodes Tumor is a rare fibro epithelial neoplasm of the breast. They resemble fibroadenomas clinically and can be mistakenly ignored sometimes. Patient concerns We report the case of a young woman with her first presentation to hospital due to a hypoglycemia and she underwent 2 excised fibroadenomas in the same breast before diagnosed of malignant Phyllodes Tumor. She was complaining about 2 masses presented in her right breast 4 months after mastectomy. Diagnoses Recurrent Phyllodes Tumor of the breast. Interventions We conducted an immediate autologous myocutaneous flap transplantation after a wide-excision. Postoperative radiotherapy was recommended. Outcomes She was in good general condition without Tumor relapses during 8 months of follow-up. Lessons Recurrent fibroadenomas in the same breast, especially those of large size with rapid growth rate, suggesting a high transformation possibility from fibroadenoma to Phyllodes Tumor. We recommend an extended Tumor resection and immediate or delayed reconstruction of the breast for the recurrent Phyllodes Tumor with separately multiple relapses.