Fibroepithelial Research Articles

Periductal Stromal Sarcoma of the Breast: A Case Report

Introduction: Periductal Stromal Sarcoma (PSS), especially spindle and epithelioid types, is a rare subtype of the malignant fibroepithelial tumor with benign ductal elements and a sarcomatous stroma composed of spindle cells. The therapeutic management of PSS is based on wide surgery with free margins, and adjuvant therapies are not required. Case Presentation: This report describes a 37-year-old woman who presented to Shariati hospital with a right breast mass for review and a second opinion pathology report. The patient had undergone a radical mastectomy in another hospital three months previously. Histological and immunohistochemical examinations revealed PSS and all dissected lymph nodes were free of tumor. Based on the diagnosis, the patient received no adjuvant treatment (such as chemotherapy or radiotherapy). After nine months of close follow-up examinations, no recurrence was observed. Conclusion: PSS is an extremely rare disease with low-grade sarcomatous behavior, which may evolve into a phyllodes tumor or an entity of breast cancer. Therefore, frequent follow-up examinations are required.

Primary Breast Tumors with Mesenchymal Morphology.

Overview Mesenchymal tumors of the breast are rare. Few epithelial tumors also have mesenchymal components. It is crucial to identify these as per histogenesis. This can be facilitated by markers of epithelial–mesenchymal transition (EMT). Objectives The aim of this study was to categorize the breast lesions with mesenchymal morphology and to study EMT on immunohistochemistry (IHC). Materials and Methods This is a retrospective study of 5-year duration from January 2015 to December 2019. Inclusion criteria: all breast lesions showing mesenchymal/nonepithelial morphology, complete or partial, on histology. Exclusion criteria: Mammary carcinomas without any mesenchymal/nonepithelial morphology, fibroadenomas, and lymphomas. Demographics, clinical, gross examination, histology, and IHC findings of selected cases were reviewed and recorded. Three additional markers p53, E-cadherin, and β-catenin were performed. Statistical Analysis Used Frequency calculation for each variable (IHC). Results Thirteen (2.5%) out of total 510 breast specimens showed mesenchymal histology. Of these, five (38.5%) were metaplastic breast carcinomas (MBC), four (31%) were phyllodes tumor (PT), and one (7.7%) case each of malignant peripheral nerve sheath tumor, primary stromal sarcoma of breast, pseudoangiomatous stromal hyperplasia, and myofibroblastoma. Loss of E-cadherin was seen in 4/5 (80%) MBCs and was retained in ductal component of PTs. p53 was not expressed in any of the tumors except 3/5 (60%) MBCs. β-Catenin was aberrant in all MBCs. Conclusions Primary breast tumors with mesenchymal morphology present a spectrum ranging from benign mesenchymal, fibroepithelial neoplasms to malignant tumors of mesenchymal and epithelial origin. Loss of E-cadherin, expression of p53, and aberrant expression of β-catenin are suggestive of EMT and molecular heterogeneity of MBCs.

A retrospective review of phyllodes tumors of the breast from a single institution.

Phyllodes tumors (PTs) are rare fibroepithelial breast tumors with diverse biological behavior. This study aimed to analyze the characteristics, management, and outcome of phyllodes tumors. Patients diagnosed with PTs in our institution from January 2013 to December 2017 were identified retrospectively by the ICD-10 code. Data were collected from medical records. The diagnosis of this tumor was based on histopathological results. Variables analyzed included age, tumor site, surgical option, axillary lymph nodes, chemotherapy and radiotherapy, metastases, disease-free survival (DFS), and overall survival (OS) rate. Sixty-nine cases of PTs were diagnosed during the period, of which 31 were benign, 38 were malignant, and 1 was a case of bilateral metachronous tumors. We did not find any borderline pathologic cases. The patient's ages ranged from 20 to 71 years, with the highest number of cases (28) from the 40-49-year-old age group. The majority of patients (42) had PT on the right side. Simple mastectomy was the most performed treatment, with 53 such cases, including both benign and malignant. The axillary staging was carried out in 16 cases, of which none had nodal metastasis. Ten cases received chemotherapy, and 16 cases of malignant phyllodes received postoperative radiotherapy. We found 4 cases with distant metastases and 5 cases that developed local recurrence. The DFS rate reached 92.75%, and the overall 5-year survival rate was 84.21%. The incidence of PTs is highest in women in the 3rd and fourth decades of age. Simple mastectomy and wide excision are the treatments of choice, with a low recurrence rate in both benign and malignant PTs cases.

LOCAL RECURRENCE OF PHYLLODES TUMORS OF THE BREAST : A META-ANALYSIS

Background: Phyllodes tumors (PTs) are uncommon fibroepithelial breast tumors that are capable of a diverse range of biologic behaviors. In their least aggressive form, phyllodes tumors behave like benign fibroadenomas, although with a propensity to recur locally following excision without wide margins.Aim of Work: Our study focused on local recurrence and various risk factors of phyllodes tumors of the breast through a meta-analysis.Patient and Methods: This Review involved case-control studies, case report studies, and retrospective case follow-up evaluating local recurrence (LR) rates of unilateral or bilateral phyllodes tumors. phyllodes tumors of breast and assessing various risk factors for LR.Results: Forty-eight studies compared the LR risk between Benign / malignant. There was significant higher in Malignant VS Benign regarding rate of local recurrence p-value <0.001. Pooling of data from twenty-three showed significant difference in the LR risk between patients who underwent breast conserving surgery (BCS) and those who had a mastectomy p-value 0.001.Conclusion: The risk of LR was significantly increased from benign to borderline to malignant PTs, type of surgery, and surgical margin status may be risk factors for LR, while mitoses, tumor border, stromal cellularity, stromal atypia, stromal overgrowth, tumor necrosis had no difference regard increase risk for LR, Different management strategies could be considered for different PT grade.

Successful Homoeopathic Treatment of Phyllodes Tumour: A Case Study

AbstractPhyllodes tumours (PTs) of the breast are rare biphasic fibroepithelial neoplasm. They have potentiality to recur and metastasise. Majority of them follow a benign clinical course. We have treated one patient suffering from PT at the out-patient department of Sri Ram Medical &amp; Homoeopathic Research Centre, Gorakhpur, India. After detailed case taking and repertorisation, first Conium maculatum and later on Phytolacca decandra and Calcarea fluorica were prescribed on the basis of individualisation to treat the case. Outcomes were assessed clinically every month for subjective improvement and objectively by ultrasonography reports at every 6-month interval. Gradual improvement was noted over time. The case has been assessed with MONARCH Inventory, which shows ‘definite’ association between the medicine and the outcome.

A Giant, Complex Fibroepithelial Tumor of the Breast: Borderline Phyllodes Tumor Combined with Tubular Adenoma - a Rare Clinical Presentation of a Fibroepithelial Tumor of the Breast.

No abstract available.

Limited Reporting of Histopathologic Details in a Multi-Institutional Academic Cohort of Phyllodes Tumors: Time for Standardization

Phyllodes tumors are rare fibroepithelial neoplasms that are classified by tiered histopathologic features. While there are protocols for the reporting of cancer specimens, no standardized reporting protocol exists for phyllodes. We performed an 11-institution contemporary review of phyllodes tumors. Granular histopathologic details were recorded, including the features specifically considered for phyllodes grade classification. Of 550 patients, median tumor size was 3.0cm, 68.9% (n=379) of tumors were benign, 19.6% (n=108) were borderline, and 10.5% (n=58) were malignant. All cases reported the final tumor size and grade classification. Complete pathologic reporting of all histopathologic features was present in 15.3% (n=84) of cases, while an additional 35.6% (n=196) were missing only one or two features in the report. Individual details regarding the degree of stromal cellularity was not reported in 53.5% (n=294) of cases, degree of stromal atypia in 58.0% (n=319) of cases, presence of stromal overgrowth in 56.2% (n=309) of cases, stromal cell mitoses in 37.5% (n=206) of cases, and tumor border in 54.2% (n=298) of cases. The final margin status (negative vs. positive) was omitted in only 0.9% of cases, and the final negative margin width was specifically reported in 73.8% of cases. Reporting of details was similar across all sites. In this academic cohort of phyllodes tumors, one or more histopathologic features were frequently omitted from the pathology report. While all features were considered by the pathologist for grading, this limited reporting reflects a lack of reporting consensus. We recommend that standardized reporting in the form of a synoptic-style cancer protocol be implemented for phyllodes tumors, similar to other rare tumors.

Complex fibroadenoma with focal ossification- an enigmatic finding in a less common tumor

Breast lumps have diverse causes including benign as well as malignant lesions. Fibroadenoma (FA) is a common cause of breast lump. Complex fibroadenomas, a particular subtype, pose diagnostic dilemmas due to confusing the radiological findings and hold higher incidence of transformation to malignancy. A 49 year old female presented with a painless lump in right breast for 2 years which appeared calcified on radiology. Excision biopsy was performed which grossly revealed an encapsulated grey-white firm to hard with cystic areas. Microscopically the sections showed a well encapsulated fibroepithelial tumor showing areas of sclerosing adenosis, hyalinization, cysts lined by cuboidal cells with eosinophilic secretions, areas of calcification and ossification. No evidence of lobular hyperplasia or in-situ carcinoma was seen. Patient was advised follow up. This case represents the unusual occurrence of complex fibroadenoma in a middle-aged female showing with ossification.

Malignant Phyllodes Tumor of the Breast: A Practice Review.

Introduction: Phyllodes tumor (PT) of the breast, particularly malignant phyllodes tumor (mPT), is a rare fibroepithelial neoplasm. A complex diagnosis is based on pathologic, radiologic, and clinical findings, with controversies about what is the best therapeutic strategy. Objective: Our objective was to provide an overview of the clinical, pathologic, and therapeutic aspects of this rare tumor. Conclusions: mPT is a rare presentation of breast cancer and a challenge in clinical practice. A multidisciplinary approach should take into account some aspects like pathogenic mutations and hereditary syndromes. Oncologic surgery is the fundamental approach, and the use of adjuvant therapies is still controversial due to the lack of clinical trials. Treatment recommendations should be individualized according to patient risk and preferences. Prospective studies are fundamental to clarifying the best treatment for these tumors.

A comprehensive study of fibroepithelial lesion of breast with special emphasis on challenges in diagnosing phyllodes tumor

Background: Fibroepthelial lesions are one of the most common benign breast disease seen in day today practice. They comprise of a wide spectrum of tumors ranging from fibroadenoma to infrequent phyllodes tumor. Evaluation of fibroepithelial lesions on FNA material or biopsy material may be sometimes under interpreted as both fibroadenoma and phylloides tumor have few common morphological features. So a detailed histopathological study is necessary to identify the hurdles in diagnosis and management of patient. This study was conducted with an aim to stratify and classify various fibroepithelial lesions, to classify phyllodes tumor according to newer WHO guidelines, to study interobserver variations in diagnosing phyllodes tumor and other associated morphological features in fibroepithelial lesion. Materials and Methods: This was retrospective study conducted in Department of Pathology, Hassan Institute of Medical Sciences, Hassan. The study was done on all breast biopsy samples received from the year January 2015 to April 2020 for a duration of 5years. Archived slides were reviewed in detail by three pathologists and fibroepithelial lesions were classified according to WHO classification of tumors of breast 2019. Results: A total of 200 fibroepithelial lesions of breast were studied. 180 cases were fibroadenoma, 18 cases were phyllodes tumor and 2 cases were benign fibroepithelial neoplasm. Interobserver variation was seen in 6 cases of benign phyllodes tumor, whereas no ambiguity was seen in diagnosis of fibroadenomas. Conclusion: Over diagnosis fibroadenomas as phyllodes tumor may have been prevented, if standard criteria were in use. Fibroadenoma and benign phyllodes tumor can be difficult to distinguish in some cases where focal leaf like growth pattern and hypercellularity can be seen. It is a good practice to evaluate the lesion as whole to come to a definitive diagnosis rather than emphasising on focal features.

Giant Phyllodes Tumor: A Case Report and Review of the Literature?

Phyllodes tumor is a rare, fast-growing, fibroepithelial neoplasm of the breast that can be classified as benign, borderline or malignant. The case reported here refers to a 25-year old patient with a lump on her left breast that grew rapidly in the postpartum period, reaching 21 cm in size. Core biopsy and immunohistochemical analysis indicated a diagnosis of high-grade phyllodes tumor. The patient underwent mastectomy of the left breast followed by breast reconstruction. Histopathology confirmed a malignant phyllodes tumor with chondrosarcomata’s and fibrosarcomatous differentiation and no angiolymphatic or perineural invasion. Phyllodes tumors are generally benign and differential diagnosis is usually made with fibroadenomas; however, clinical differentiation can be difficult in some cases. The definitive diagnosis is achieved by histopathology, which is able to differentiate benign from malignant forms of the disease. Standard treatment consists of local excision, with mastectomy being necessary in cases of borderline, large, malignant or recurrent tumors.

Comparison of P-53, Ki-67 and Cd-10 Expression Between Fibroadenoma, Benign Phyllodes Tumor and Malignant Phyllodes Tumor

Background: Fibroepithelial tumors of the breast are a heterogeneous group of biphasic lesions comprising of an epithelial component and a quantitatively predominant mesenchymal component. These are classified into two major categories: Fibroadenoma and phyllodes tumor (PT). Phyllodes tumors are classified into benign, borderline and malignant grade categories based on histological parameters.&#x0D; Methods: An analytical-cross sectional study was conducted in the Department of Pathology, Hindu Rao Hospital, Delhi-110007 from November 2016 to December 2018. Total 50 cases were included in the study comprising of 30 cases of fibroadenoma, 15 cases of benign phyllodes tumor and 5 cases of malignant phyllodes tumor. All specimens were fixed in 10% buffered formalin. Tissue were processed and embedded in paraffin. The sections were stained with hematoxylin and eosin (H&amp;E) to study the histopathological section. Immunostaining using CD-10, Ki-67 and p53 antibodies was done in all cases.&#x0D; Result: Among fibroadenoma cases only 3.33% showed positive CD-10 expression and 96.66% were negative. CD-10 expression was positive in 26.67% cases of benign phyllodes while 73.33 showed negative expression. 40% malignant phyllodes cases showed positive CD-10 expression and 60% showed negative CD-10 expression. CD-10 expression was significantly higher in benign phyllodes (p value = 0.019) and malignant phyllodes (p value 0.007) group as compared to fibroadenoma. P-53 expression in epithelium was seen in 56% of fibroadenoma and 26% of benign phyllodes cases, while all cases of malignant phyllodes tumor show negative P-53 expression. The stromal expression of P-53 was significantly higher in malignant phyllodes as compared to fibroadenoma and benign phyllodes tumor. Stromal expression of Ki-67 was significantly higher in malignant phyllodes as compared to benign phyllodes and fibroadenoma. Epithelial expression of Ki-67 was negative in all malignant phyllodes cases while positive epithelial Ki-67 expression was seen in 56% of fibroadenoma and 33% of benign phyllodes tumor.&#x0D; Conclusion: Both Ki-67 and P-53 showed a significantly increasing expression from fibroadenoma to benign phyllodes to malignant phyllodes tumor. The difference in expression of CD-10 was insignificant among fibroadenoma, benign phyllodes and malignant phyllodes tumor.

Phyllodic tumors of the breast: Frequency and anatomo-histoclinical aspects at Conakry University Teaching Hospital (CHU). Guinea

Objectives: Calculate the frequency of phyllodes tumors of the breast, describe the epidemiological profile and describe the anatomo-histoclinical aspects of phyllodes tumors of the breast at the Conakry University Teaching Hospital. Methodology: This was a retrospective descriptive type study lasting 10 years, from January 1, 2008 to December 31, 2018. It concerned all cases of breast lesions, the parts that were examined in the anatomo-pathological laboratory. All cases of mammary tumours were included for the diagnosis of phyllodes tumor which was histologically confirmed. All cases of breast lesions for which the diagnosis was histologically ruled out were excluded. We carried out an exhaustive examination of the data available in the registers of the anatomo-pathologies service of the Conakry University Teaching Hospital. . The limitations or constraints of the study were the absence of certain information on the pathological examination request forms and the absence of an immunohistochemical study. Results: The frequency of phyllodes tumors was 02.72% (n = 22) among benign and malignant breast pathologies (n = 807) and 1.65% among those of genital and breast pathologies (n = 1334). The epidemiologic profile was that of a woman in the age group 50-59 (27.27%), nulliparous (45.45%). Inflammation was the main reason for consultation (100%). The main presumptive clinical diagnosis was benign tumor (54.54%). Lumpectomy was the main surgical procedure (36.36%) followed by excised biopsies (27.27%). Cases of phyllodes with a consistency firm were the most observed (50%) followed by cases with associated consistency 6 cases (27.27%). Phyllodes tumours without rearrangements represented (63.63%) followed by cases with associated rearrangements (13.63%). Grade I constituted the majority of the histological grade found (54.54%) followed by grade II (22.73%). Phyllodes tumors with benign behavior constituted the majority of cases observed 17 (77.27%). Tumors resected in a healthy zone were the most represented (72.73%). The histologic types with good prognosis constituted the majority of our diagnosed cases (77.27%). Conclusion: Phyllodes tumours constitute of a particular histological type of fibroepithelial tumours of the breast. They constitute a predominantly benign tumor, its malignant forms consist of high-grade sarcomas, often with a poor prognosis. They affect all ages, but especially women between the third and fifth decade. Their diagnosis is exclusively histological, which makes it possible to assess to their behavior, grade and histological prognosis

Missed Diagnosis of Phyllodes Tumour And Its Implications - A Case Report

Phyllodes tumours are rare fibroepithelial tumours that accounts for less than 1% of all breast tumours. Phyllodes tumours tend to grow quickly but they rarely spread outside the breast. Although most phyllodes tumours are benign, some are malignant and some are borderline. It is often underdiagnosed by pathologists and under treated by surgeon. Its heterogenicity makes phyllodes tumour a challenge for the clinicians and the pathologists. Accurate preoperative diagnosis by Fine Needle Aspiration Cytology or by Core biopsy or peroprative diagnosis by Frozen section biopsy is essential for adequate surgical treatment. This case describes a missed diagnosis of phyllodes tumour both by cytopathologically and histopathologically.&#x0D; J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 182-184

Core needle biopsy in fibroepithelial tumors: predicting factors for phyllodes tumors

OBJECTIVES:This study aimed to evaluate the clinical and imaging predictive factors for the diagnosis of phyllodes tumors in patients with inconclusive results from core needle biopsy (fibroepithelial lesions).METHODS:We retrospectively analyzed data of patients who underwent surgical excision of breast lesions previously diagnosed as fibroepithelial lesions. Numeric variables were analyzed using the Shapiro-Wilk and t-tests, and categorical variables were analyzed using the chi-square and Fisher’s exact tests. Multivariate logistic regression was performed to calculate odds ratios and detect predictive factors for the diagnosis of PT.RESULTS:A total of 89 biopsy samples were obtained from 77 patients, of which 43 were confirmed as fibroadenomas, 43 as phyllodes tumors, and 3 as other benign, non-fibroepithelial breast lesions. The mean tumor size was 3.61 cm (range, 0.8-10 cm) for phyllodes tumors and 2.4 cm (range, 0.8-7.9 cm) for fibroadenomas. The predictive factor for phyllodes tumor diagnosis was lesion size >3 cm (p<0.001).CONCLUSION:Our data indicate that fibroepithelial lesions of the breast larger than 3 cm are more likely to be phyllodes tumors.

Radiological Aspect of Unusual Case of Rapidly Growing Giant Phyllodes Tumour of Breast

Phyllodes tumour or cystosarcoma phyllodes are a rare fibroepithelial tumour of breast, predominantly affecting the adult woman of age group 40-60 years. This is a case report of unusual, rapidly growing giant phyllodes in a 58-year-old women who came with history of enlarging lump in right breast without any significant pain or nipple discharge and was referred to the Radiology Department for mammographic and sonomammographic evaluation by the referring breast surgeon. This case is unique, since it describes how a rapidly growing breast lump is not always a sinister breast carcinoma but can be a benign, borderline or malignant phyllodes all of which can mimic a carcinoma in signs and symptoms, but hold a better prognosis. The final diagnosis of borderline phyllodes tumour was made on core biopsy followed by mastectomy of the involved breast. The main take away of this case report is how by having high level of suspicion, knowledge of specific imaging characteristics, correct biopsy technique combined with histopathology can help in reaching to a correct diagnosis leading to proper patient care and management.

A cellular fibroepithelial tumor of the breast: A case report

Introduction: Fibroepithelial breast lesions are biphasic neoplasms characterized by proliferation of both stromal and epithelial cells. They encompass a spectrum of tumors ranging from benign fibroadenoma to potentially fatal malignant phyllodes tumor, with tumors of borderline clinical significance in-between. It is important to correctly characterize each lesion, as this defines management and thus risk of local recurrence and potential distant metastasis in case of malignancy. Case Report: A 48-year-old woman presented with a palpable retro-areolar lump in the left breast. After core biopsy, the initial pathology report initiated tumorectomy. When the final report stated a borderline phyllodes tumor with incomplete resection, reintervention was needed with wide surgical margins to avoid local recurrence. The local re-excision showed scarring and steatonecrosis as a result of the previous procedure, but no residual lesion. Consequently, there was no need for further surgical intervention. Conclusion: Fibroepithelial lesions (FEL) of the breast are a wide variety of lesions with distinct management based on the exact pathologic character. Core needle biopsy poses a risk of sampling error due to intratumoral heterogeneity that sometimes may be found in cellular FEL. As a consequence, upgrading at the time of the excision specimen can frequently occur with need of reintervention.

Phyllodes Tumors of the Breast: A Single-Center Experience

We aimed to analyze the clinicopathological findings, treatment approach, and treatmen outcomes in patients diagnosed with phyllodes tumor (PT). The clinicopathological data of 26 patients with PT, who were treated between 2008 and 2019, were retrospectively analyzed. Mean age was 35.07±13.95 years (range: 14-71), while mean tumor size was 54.76±29.24 mm (range: 25-135). Benign, borderline, and malignant PT were detected in 18 (69.2%), 3 (11.5%), and 5 (19.2%) patients, respectively. Marginless excision was performed in 20 patients (76.9%), while six (23.1%) patients underwent mastectomy. A statistically significant correlation of tumor type with mean tumor size and mean age was observed (p=0.041 and p=0.013, respectively). Margin positivity on first excision was more frequent in the malignant tumors (p=0.02). No statistically significant correlation of PT type with presence of breast cancer in the family history, and tumor localization was observed (p=0.79 and p=0.13, respectively). Mean postoperative follow-up duration was 56 months (range: 6-147). Local recurrence was not observed in any of the patients. Lung and left vastus lateralis muscle metastases were encountered. The patient with lung metastasis became exitus because of the same reason 6 months after detection of the metastasis. PT is a rare fibroepithelial tumor of the breast that is characterized by a mixed histology seen in younger ages when compared to the classical breast tumors. The probability of PT should be considered in the presence of a rapid-growing mass in the breast. In addition, it should also be considered that the contribution of imaging techniques may be limited.

A study of phyllode tumors, pathological parameters, and clinical correlations

Objectives Phyllode tumors (PTs) represent a unique entity as mixed fibroepithelial tumors of the breast, which are characterized by a particular histologic appearance, and biologically by frequent local recurrence and low metastatic potential. We aim to study patients with PTs to determine the different histopathological features regarding, tumor grade, margin, hemorrhage, heterologous differentiation, and clinical correlations regarding age, sex, site, local recurrence, and distant metastasis in Sudanese patients. Materials and methods This descriptive retrospective study was carried out on PT specimens obtained from the Pathology Department at National Health Laboratory (NHL), Soba University Hospital (SUH), and Khartoum Teaching Hospital (KTH) during the interval between January 2008 and December 2011. Clinical data were collected from patients’ request forms. The slides were reexamined by two histopathologists using WHO classification of PTs, 2012. The data were analyzed using Statistical Package for Social Sciences. Results The study included 59 specimens diagnosed as PTs. After reexamination of the slides, two cases were excluded, one being a spindle-cell sarcoma and another being a fibroadenoma. The age of the patients ranged from 18 to 80 years. The most common affected age group was 21–40 years. The mean age was 35±1.75 years, and all of them were females. The tumors were found to occur with an equal propensity in either breast. In total, 18 (35.3%) cases were considered histologically benign, 28 (54.9%) cases were considered malignant, and five (9.8%) cases were classified as borderline. Pushing margins were present in all the cases, except three histologically malignant cases, in which the margin was infiltrative. A statistically significant positive relationship was present between tumor grade and presence of hemorrhage (P&lt;0.05). Tumor size was significantly related to histological grade also (P&lt;0.04). However, an insignificant relation was present between local recurrence and tumor grade (P&lt;0.065). Heterologous mesenchymal differentiation was present only in histologically malignant cases. Regional lymph-node involvement was not detected in any of the studied cases. Conclusion In our study, PTs occurred exclusively in females, commonly in the age group 21–40 years, the mean age in our study was 35 years, which is 5 years younger than the mean age reported in the literature, with no reporting of cases below 18 years. Malignant lesions outnumbered the benign lesions. Heterologous differentiation, hemorrhage, large tumor size, and infiltrating tumor margin are positively related to histologically malignant cases. Local recurrence was not significantly related to malignant phenotype, it may reflect the importance of adequate surgical margin.

Phyllodes tumor of the breast- Cytohistological study

Introduction: Phyllodes tumor constitutes an uncommon group of mammary fibroepithelial neoplasm, having incidence of about 0.3% to 1% of breast tumors. The median age of occurrence of disease is 40 to 50 years. These tumors were first recognized by Muller, who used the term “cystosarcoma phyllodes” (phyllos = leaf, Greek). The differential diagnosis between phyllodes tumor & fibroadenoma and histological grading of phyllodes tumor is challenging. Material and Methods: Retrospective data from cytology and histopathology record in pathology Department, Muzaffarnagar Medical College, Muzaffarnagar showed seven cases of phyllodes tumor. In all cases, Fine Needle Aspiration Cytology (FNAC) was initially performed and was further confirmed on histopathology. Results: The age range of these patients was from 18 to 61 years. The size of the breast lesion ranged from 6x5 cms to 40x30 cms. Tumors were classified according to WHO grading system based on the degree of stromal cellularity and atypia, presence or absence of stromal overgrowth, mitotic count and nature of tumor margin. Out of seven cases, two cases of were reported as benign phyllodes tumor, four as borderline and one as malignant. Two cases recurred within one year, one was benign and other one was diagnosed as borderline. Conclusion: Preoperative diagnosis and proper management is important in phyllodes tumor to minimize the recurrence and malignant potential. So, accurate diagnosis of phyllodes tumor is crucial so that they are effectively treated. Treatment include wide surgical excision with negative margins. Keywords: Breast, Phyllodes, Fibroadenoma, Classification, Fibroepithelial neoplasm.