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Malignant transformation of breast fibroadenoma to malignant phyllodes tumor: long-term outcome of 36 malignant phyllodes tumors

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Abstract

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.

Methods

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.

Results

The outcome of cases with history of fibroadenoma was significantly better than that of cases without history of fibroadenoma.

Conclusions

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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Acknowledgments

We are grateful for the secretarial assistance provided by Ms. Rie Gokan.

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Authors and Affiliations

  1. Department of Breast Oncology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Makoto Abe, Seiichiro Nishimura, Kotaro Iijima, Masujiro Makita & Takuji Iwase

  2. Department of Genome Center, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Satoshi Miyata

  3. Department of Pathology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Futoshi Akiyama

  4. Department of Breast Surgery, Murakami Memorial Hospital, Asahi University, 3-23 Hashimoto-cho, Gifu, 500-8523, Japan

    Makoto Abe

Authors
  1. Makoto Abe
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  2. Satoshi Miyata
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  3. Seiichiro Nishimura
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  4. Kotaro Iijima
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  5. Masujiro Makita
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  6. Futoshi Akiyama
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  7. Takuji Iwase
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Correspondence to Makoto Abe.

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Abe, M., Miyata, S., Nishimura, S. et al. Malignant transformation of breast fibroadenoma to malignant phyllodes tumor: long-term outcome of 36 malignant phyllodes tumors. Breast Cancer 18, 268–272 (2011). https://doi.org/10.1007/s12282-009-0185-x

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  • DOI: https://doi.org/10.1007/s12282-009-0185-x

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