TY - JOUR T1 - Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins JF - Journal of Clinical Pathology JO - J Clin Pathol DO - 10.1136/jclinpath-2011-200368 SP - jclinpath-2011-200368 AU - Puay Hoon Tan AU - Aye Aye Thike AU - Wai Jin Tan AU - Minn Minn Myint Thu AU - Inny Busmanis AU - HuiHua Li AU - Wen Yee Chay AU - Min‐Han Tan AU - The Phyllodes Tumour Network Singapore Y1 - 2011/01/01 UR - http://jcp.bmj.com/content/early/2011/11/01/jclinpath-2011-200368.abstract N2 - Aim To define a predictive model for clinical behaviour of breast phyllodes tumours (PT) using histological parameters and surgical margin status.Methods Cases of breast PT diagnosed in the Department of Pathology Singapore General Hospital between January 1992 and December 2010 were stratified into benign, borderline and malignant grades based on a combination of histological parameters (stromal atypia, hypercellularity, mitoses, overgrowth and nature of tumour borders). Surgical margin status was assessed. Clinical follow-up and biostatistical modelling were accomplished.Results Of 605 PT, 440 (72.7%) were benign, 111 (18.4%) borderline and 54 (8.9%) malignant. Recurrences, which were predominantly local, were documented in 80 (13.2%) women. Deaths from PT occurred in 12 (2%) women. Multivariate analysis revealed stromal atypia, overgrowth and surgical margins to be independently predictive of clinical behaviour, with mitoses achieving near significance. Stromal hypercellularity and tumour borders were not independently useful. A nomogram developed based on atypia, mitoses, overgrowth and surgical margins (AMOS criteria) could predict recurrence-free survival at 1, 3, 5 and 10 years. This nomogram was superior to a total histological score derived from adding values assigned to each of five histological parameters.Conclusion A predictive nomogram based on three histological criteria and surgical margin status can be used to calculate recurrence-free survival of an individual woman diagnosed with PT. This can be applied for patient counselling and clinical management. ER -