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. 2001 Jul;77(909):428–435. doi: 10.1136/pmj.77.909.428

Phyllodes tumours

S Parker 1, S Harries 1
PMCID: PMC1760996  PMID: 11423590

Abstract

Phyllodes tumours are rare fibroepithelial lesions that account for less than 1% of all breast neoplasms. With the non-operative management of fibroadenomas widely adopted, the importance of phyllodes tumours today lies in the need to differentiate them from other benign breast lesions. All breast lumps should be triple assessed and the diagnosis of a phyllodes tumour considered in women, particularly over the age of 35 years, who present with a rapidly growing "benign" breast lump. Treatment can be by either wide excision or mastectomy provided histologically clear specimen margins are ensured. Nodal metastases are rare and routine axillary dissection is not recommended. Few reliable clinical and histological prognostic factors have been identified. Local recurrence occurs in approximately 15% of patients and is more common after incomplete excision. It can usually be controlled by further surgery. Repeated local recurrence has been reported without the development of distant metastases or reduced survival. Approximately 20% of patients with malignant phyllodes tumours develop distant metastases. Long term survival with distant metastases is rare. The role of chemotherapy, radiotherapy, and hormonal manipulation in both the adjuvant and palliative settings remain to be defined.


Keywords: benign breast disease; fibroadenoma; phyllodes tumour

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Selected References

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  1. Al-Jurf A., Hawk W. A., Crile G., Jr Cystosarcoma phyllodes. Surg Gynecol Obstet. 1978 Mar;146(3):358–364. [PubMed] [Google Scholar]
  2. Allen R., Nixon D., York M., Coleman J. Successful chemotherapy for cystosarcoma phyllodes in a young woman. Arch Intern Med. 1985 Jun;145(6):1127–1128. [PubMed] [Google Scholar]
  3. Amerson J. R. Cystosarcoma phyllodes in adolescent females. A report of seven patients. Ann Surg. 1970 Jun;171(6):849–856. doi: 10.1097/00000658-197006010-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Aranda F. I., Laforga J. B., López J. I. Phyllodes tumor of the breast. An immunohistochemical study of 28 cases with special attention to the role of myofibroblasts. Pathol Res Pract. 1994 May;190(5):474–481. doi: 10.1016/S0344-0338(11)80210-4. [DOI] [PubMed] [Google Scholar]
  5. BADER E., ISAACSON C. Bilateral malignant cystosarcoma phyllodes. Br J Surg. 1961 Mar;48:519–521. doi: 10.1002/bjs.18004821111. [DOI] [PubMed] [Google Scholar]
  6. Baley P. A., Resink T. J., Eppenberger U., Hahn A. W. Endothelin messenger RNA and receptors are differentially expressed in cultured human breast epithelial and stromal cells. J Clin Invest. 1990 Apr;85(4):1320–1323. doi: 10.1172/JCI114570. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Bartoli C., Zurrida S., Veronesi P., Bono A., Chiesa F., Cosmacini P., Clemente C. Small sized phyllodes tumor of the breast. Eur J Surg Oncol. 1990 Jun;16(3):215–219. [PubMed] [Google Scholar]
  8. Bennett I. C., Khan A., De Freitas R., Chaudary M. A., Millis R. R. Phyllodes tumours: a clinicopathological review of 30 cases. Aust N Z J Surg. 1992 Aug;62(8):628–633. doi: 10.1111/j.1445-2197.1992.tb07534.x. [DOI] [PubMed] [Google Scholar]
  9. Bennett I. C., Khan A., De Freitas R., Chaudary M. A., Millis R. R. Phyllodes tumours: a clinicopathological review of 30 cases. Aust N Z J Surg. 1992 Aug;62(8):628–633. doi: 10.1111/j.1445-2197.1992.tb07534.x. [DOI] [PubMed] [Google Scholar]
  10. Bernstein L., Deapen D., Ross R. K. The descriptive epidemiology of malignant cystosarcoma phyllodes tumors of the breast. Cancer. 1993 May 15;71(10):3020–3024. doi: 10.1002/1097-0142(19930515)71:10<3020::aid-cncr2820711022>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  11. Bissett D., Mallon E., Reed N. S., George W. D., Harnett A. N. Cystosarcoma phylloides: heterogeneity in a rare tumour type. J R Coll Surg Edinb. 1996 Aug;41(4):244–245. [PubMed] [Google Scholar]
  12. Blichert-Toft M., Hansen J. P., Hansen O. H., Schiodt T. Clinical course of cystosarcoma phyllodes related to histologic appearance. Surg Gynecol Obstet. 1975 Jun;140(6):929–932. [PubMed] [Google Scholar]
  13. Brentani M. M., Nagai M. A., Oshima C. T., Pacheco M. M., Góes J. C., Lemos L. B. Steroid receptors in cystosarcoma phyllodes. Cancer Detect Prev. 1982;5(2):211–219. [PubMed] [Google Scholar]
  14. Briggs R. M., Walters M., Rosenthal D. Cystosarcoma phylloides in adolescent female patients. Am J Surg. 1983 Dec;146(6):712–714. doi: 10.1016/0002-9610(83)90324-0. [DOI] [PubMed] [Google Scholar]
  15. Buchanan E. B. Cystosarcoma phyllodes and its surgical management. Am Surg. 1995 Apr;61(4):350–355. [PubMed] [Google Scholar]
  16. Buchberger W., Strasser K., Heim K., Müller E., Schröcksnadel H. Phylloides tumor: findings on mammography, sonography, and aspiration cytology in 10 cases. AJR Am J Roentgenol. 1991 Oct;157(4):715–719. doi: 10.2214/ajr.157.4.1654022. [DOI] [PubMed] [Google Scholar]
  17. Burton G. V., Hart L. L., Leight G. S., Jr, Iglehart J. D., McCarty K. S., Jr, Cox E. B. Cystosarcoma phyllodes. Effective therapy with cisplatin and etoposide chemotherapy. Cancer. 1989 Jun 1;63(11):2088–2092. doi: 10.1002/1097-0142(19890601)63:11<2088::aid-cncr2820631103>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  18. Cant P. J., Madden M. V., Close P. M., Learmonth G. M., Hacking E. A., Dent D. M. Case for conservative management of selected fibro-adenomas of the breast. Br J Surg. 1987 Sep;74(9):857–859. doi: 10.1002/bjs.1800740936. [DOI] [PubMed] [Google Scholar]
  19. Chua C. L., Thomas A., Ng B. K. Cystosarcoma phyllodes--Asian variations. Aust N Z J Surg. 1988 Apr;58(4):301–305. [PubMed] [Google Scholar]
  20. Chua C. L., Thomas A., Ng B. K. Cystosarcoma phyllodes: a review of surgical options. Surgery. 1989 Feb;105(2 Pt 1):141–147. [PubMed] [Google Scholar]
  21. Ciatto S., Bonardi R., Cataliotti L., Cardona G. Phyllodes tumor of the breast: a multicenter series of 59 cases. Coordinating Center and Writing Committee of FONCAM (National Task Force for Breast Cancer), Italy. Eur J Surg Oncol. 1992 Dec;18(6):545–549. [PubMed] [Google Scholar]
  22. Cohn-Cedermark G., Rutqvist L. E., Rosendahl I., Silfverswärd C. Prognostic factors in cystosarcoma phyllodes. A clinicopathologic study of 77 patients. Cancer. 1991 Nov 1;68(9):2017–2022. doi: 10.1002/1097-0142(19911101)68:9<2017::aid-cncr2820680929>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  23. Contarini O., Urdaneta L. F., Hagan W., Stephenson S. E., Jr Cystosarcoma phylloides of the breast: a new therapeutic proposal. Am Surg. 1982 Apr;48(4):157–166. [PubMed] [Google Scholar]
  24. Cosmacini P., Zurrida S., Veronesi P., Bartoli C., Coopmans de Yoldi G. F. Phyllode tumor of the breast: mammographic experience in 99 cases. Eur J Radiol. 1992 Jul-Aug;15(1):11–14. doi: 10.1016/0720-048x(92)90194-e. [DOI] [PubMed] [Google Scholar]
  25. Deen S. A., McKee G. T., Kissin M. W. Differential cytologic features of fibroepithelial lesions of the breast. Diagn Cytopathol. 1999 Feb;20(2):53–56. doi: 10.1002/(sici)1097-0339(199902)20:2<53::aid-dc1>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  26. Dusenbery D., Frable W. J. Fine needle aspiration cytology of phyllodes tumor. Potential diagnostic pitfalls. Acta Cytol. 1992 Mar-Apr;36(2):215–221. [PubMed] [Google Scholar]
  27. Dyer N. H., Bridger J. E., Taylor R. S. Cystosarcoma phylloides. Br J Surg. 1966 May;53(5):450–455. doi: 10.1002/bjs.1800530517. [DOI] [PubMed] [Google Scholar]
  28. Faraci R. P., Schour L. Radical treatment of recurrent cytosarcoma phylloides. Ann Surg. 1974 Nov;180(5):796–798. doi: 10.1097/00000658-197411000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Farria D. M., Gorczyca D. P., Barsky S. H., Sinha S., Bassett L. W. Benign phyllodes tumor of the breast: MR imaging features. AJR Am J Roentgenol. 1996 Jul;167(1):187–189. doi: 10.2214/ajr.167.1.8659370. [DOI] [PubMed] [Google Scholar]
  30. Feakins R. M., Mulcahy H. E., Nickols C. D., Wells C. A. p53 expression in phyllodes tumours is associated with histological features of malignancy but does not predict outcome. Histopathology. 1999 Aug;35(2):162–169. doi: 10.1046/j.1365-2559.1999.00682.x. [DOI] [PubMed] [Google Scholar]
  31. Fernandez B. B., Hernanzez F. J., Spindler W. Metastatic cystosarcoma phyllodes: a light and electron microscopic study. Cancer. 1976 Apr;37(4):1737–1746. doi: 10.1002/1097-0142(197604)37:4<1737::aid-cncr2820370419>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
  32. Fiks A. Cystosarcoma phyllodes of the mammary gland--Müller's tumor. For the 180th birthday of Johannes Müller. Virchows Arch A Pathol Anat Histol. 1981;392(1):1–6. doi: 10.1007/BF00430543. [DOI] [PubMed] [Google Scholar]
  33. Grimes M. M. Cystosarcoma phyllodes of the breast: histologic features, flow cytometric analysis, and clinical correlations. Mod Pathol. 1992 May;5(3):232–239. [PubMed] [Google Scholar]
  34. Hajdu S. I., Espinosa M. H., Robbins G. F. Recurrent cystosarcoma phyllodes: a clinicopathologic study of 32 cases. Cancer. 1976 Sep;38(3):1402–1406. doi: 10.1002/1097-0142(197609)38:3<1402::aid-cncr2820380346>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  35. Halverson J. D., Hori-Rubaina J. M. Cystosarcoma phyllodes of the breast. Am Surg. 1974 May;40(5):295–301. [PubMed] [Google Scholar]
  36. Hart J., Layfield L. J., Trumbull W. E., Brayton D., Barker W. F., Giuliano A. E. Practical aspects in the diagnosis and management of cystosarcoma phyllodes. Arch Surg. 1988 Sep;123(9):1079–1083. doi: 10.1001/archsurg.1988.01400330055008. [DOI] [PubMed] [Google Scholar]
  37. Hart W. R., Bauer R. C., Oberman H. A. Cystosarcoma phyllodes. A clinicopathologic study of twenty-six hypercellular periductal stromal tumors of the breast. Am J Clin Pathol. 1978 Aug;70(2):211–216. doi: 10.1093/ajcp/70.2.211. [DOI] [PubMed] [Google Scholar]
  38. Hawkins R. E., Schofield J. B., Fisher C., Wiltshaw E., McKinna J. A. The clinical and histologic criteria that predict metastases from cystosarcoma phyllodes. Cancer. 1992 Jan 1;69(1):141–147. doi: 10.1002/1097-0142(19920101)69:1<141::aid-cncr2820690125>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  39. Hawkins R. E., Schofield J. B., Wiltshaw E., Fisher C., McKinna J. A. Ifosfamide is an active drug for chemotherapy of metastatic cystosarcoma phyllodes. Cancer. 1992 May 1;69(9):2271–2275. doi: 10.1002/1097-0142(19920501)69:9<2271::aid-cncr2820690911>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  40. Hines J. R., Murad T. M., Beal J. M. Prognostic indicators in cystosarcoma phylloides. Am J Surg. 1987 Mar;153(3):276–280. doi: 10.1016/0002-9610(87)90601-5. [DOI] [PubMed] [Google Scholar]
  41. Hiyama E., Gollahon L., Kataoka T., Kuroi K., Yokoyama T., Gazdar A. F., Hiyama K., Piatyszek M. A., Shay J. W. Telomerase activity in human breast tumors. J Natl Cancer Inst. 1996 Jan 17;88(2):116–122. doi: 10.1093/jnci/88.2.116. [DOI] [PubMed] [Google Scholar]
  42. Holthouse D. J., Smith P. A., Naunton-Morgan R., Minchin D. Cystosarcoma phyllodes: the Western Australian experience. Aust N Z J Surg. 1999 Sep;69(9):635–638. doi: 10.1046/j.1440-1622.1999.01654.x. [DOI] [PubMed] [Google Scholar]
  43. Hopkins M. L., McGowan T. S., Rawlings G., Liu F. F., Fyles A. W., Yeoh J. L., Manchul L., Levin W. Phylloides tumor of the breast: a report of 14 cases. J Surg Oncol. 1994 Jun;56(2):108–112. doi: 10.1002/jso.2930560213. [DOI] [PubMed] [Google Scholar]
  44. Iau P. T., Lim T. C., Png D. J., Tan W. T. Phyllodes tumour: an update of 40 cases. Ann Acad Med Singapore. 1998 Mar;27(2):200–203. [PubMed] [Google Scholar]
  45. Inoshita S. Phyllodes tumor (cystosarcoma phyllodes) of the breast. A clinicopathologic study of 45 cases. Acta Pathol Jpn. 1988 Jan;38(1):21–33. doi: 10.1111/j.1440-1827.1988.tb01069.x. [DOI] [PubMed] [Google Scholar]
  46. Jorge Blanco A., Vargas Serrano B., Rodríguez Romero R., Martínez Cendejas E. Phyllodes tumors of the breast. Eur Radiol. 1999;9(2):356–360. doi: 10.1007/s003300050680. [DOI] [PubMed] [Google Scholar]
  47. Kessinger A., Foley J. F., Lemon H. M., Miller D. M. Metastatic cystosarcoma phyllodes: a case report and review of the literature. J Surg Oncol. 1972;4(2):131–147. doi: 10.1002/jso.2930040208. [DOI] [PubMed] [Google Scholar]
  48. LESTER J., STOUT A. P. Cystosarcoma phyllodes. Cancer. 1954 Mar;7(2):335–353. doi: 10.1002/1097-0142(195403)7:2<335::aid-cncr2820070219>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  49. Layfield L. J., Hart J., Neuwirth H., Bohman R., Trumbull W. E., Giuliano A. E. Relation between DNA ploidy and the clinical behavior of phyllodes tumors. Cancer. 1989 Oct 1;64(7):1486–1489. doi: 10.1002/1097-0142(19891001)64:7<1486::aid-cncr2820640721>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  50. Liberman L., Bonaccio E., Hamele-Bena D., Abramson A. F., Cohen M. A., Dershaw D. D. Benign and malignant phyllodes tumors: mammographic and sonographic findings. Radiology. 1996 Jan;198(1):121–124. doi: 10.1148/radiology.198.1.8539362. [DOI] [PubMed] [Google Scholar]
  51. Lindquist K. D., van Heerden J. A., Weiland L. H., Martin J. K., Jr Recurrent and metastatic cystosarcoma phyllodes. Am J Surg. 1982 Sep;144(3):341–343. doi: 10.1016/0002-9610(82)90016-2. [DOI] [PubMed] [Google Scholar]
  52. Lyons K., Gravelle I. H., Jones A. D. The radiology of phyllodes tumour. Br J Clin Pract Suppl. 1989 Nov;68:147–158. [PubMed] [Google Scholar]
  53. Maier W. P., Rosemond G. P., Wittenberg P., Tassoni E. M. Cytosarcoma phyllodes mammae. Oncology. 1968;22(2):145–158. doi: 10.1159/000224446. [DOI] [PubMed] [Google Scholar]
  54. Mangi A. A., Smith B. L., Gadd M. A., Tanabe K. K., Ott M. J., Souba W. W. Surgical management of phyllodes tumors. Arch Surg. 1999 May;134(5):487–493. doi: 10.1001/archsurg.134.5.487. [DOI] [PubMed] [Google Scholar]
  55. McDONALD J. R., HARRINGTON S. W. Giant fibro-adenoma of the breast, cystosarcoma phyllodes. Ann Surg. 1950 Feb;131(2):243-51, illust. doi: 10.1097/00000658-195002000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. McDivitt R. W., Urban J. A., Farrow J. H. Cystosarcoma phyllodes. Johns Hopkins Med J. 1967 Jan;120(1):33–45. [PubMed] [Google Scholar]
  57. McGregor G. I., Knowling M. A., Este F. A. Sarcoma and Cystosarcoma phyllodes tumors of the breast--a retrospective review of 58 cases. Am J Surg. 1994 May;167(5):477–480. doi: 10.1016/0002-9610(94)90238-0. [DOI] [PubMed] [Google Scholar]
  58. Millar E. K., Beretov J., Marr P., Sarris M., Clarke R. A., Kearsley J. H., Lee C. S. Malignant phyllodes tumours of the breast display increased stromal p53 protein expression. Histopathology. 1999 Jun;34(6):491–496. doi: 10.1111/j.1365-2559.1999.00666.x. [DOI] [PubMed] [Google Scholar]
  59. Modena S., Prati G., Mainente M., Massocco A., Montresor E., Pelosi G., Iannucci A. Phyllodes tumor of the breast: problems of differential diagnosis and therapeutic approach from an analysis of 17 cases. Eur J Surg Oncol. 1993 Feb;19(1):70–73. [PubMed] [Google Scholar]
  60. Moffat C. J., Pinder S. E., Dixon A. R., Elston C. W., Blamey R. W., Ellis I. O. Phyllodes tumours of the breast: a clinicopathological review of thirty-two cases. Histopathology. 1995 Sep;27(3):205–218. doi: 10.1111/j.1365-2559.1995.tb00212.x. [DOI] [PubMed] [Google Scholar]
  61. Mokbel K., Ghilchik M., Parris C. N., Newbold R. F. Telomerase activity in phyllodes tumours. Eur J Surg Oncol. 1999 Aug;25(4):352–355. doi: 10.1053/ejso.1999.0656. [DOI] [PubMed] [Google Scholar]
  62. Mokbel K., Price R. K., Mostafa A., Wells C. A., Carpenter R. Phyllodes tumour of the breast: a retrospective analysis of 30 cases. Breast. 1999 Oct;8(5):278–281. doi: 10.1054/brst.1999.0058. [DOI] [PubMed] [Google Scholar]
  63. Moore M. P., Kinne D. W. Breast sarcoma. Surg Clin North Am. 1996 Apr;76(2):383–392. doi: 10.1016/s0039-6109(05)70445-x. [DOI] [PubMed] [Google Scholar]
  64. Murad T. M., Hines J. R., Beal J., Bauer K. Histopathological and clinical correlations of cystosarcoma phyllodes. Arch Pathol Lab Med. 1988 Jul;112(7):752–756. [PubMed] [Google Scholar]
  65. Nambiar R., Kutty M. K. Giant fibro-adenoma (cystosarcoma phyllodes) in adolescent females--a clinicopathological study. Br J Surg. 1974 Feb;61(2):113–117. doi: 10.1002/bjs.1800610210. [DOI] [PubMed] [Google Scholar]
  66. Noguchi S., Motomura K., Inaji H., Imaoka S., Koyama H. Clonal analysis of fibroadenoma and phyllodes tumor of the breast. Cancer Res. 1993 Sep 1;53(17):4071–4074. [PubMed] [Google Scholar]
  67. Noguchi S., Yokouchi H., Aihara T., Motomura K., Inaji H., Imaoka S., Koyama H. Progression of fibroadenoma to phyllodes tumor demonstrated by clonal analysis. Cancer. 1995 Nov 15;76(10):1779–1785. doi: 10.1002/1097-0142(19951115)76:10<1779::aid-cncr2820761015>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
  68. Norris H. J., Taylor H. B. Relationship of histologic features to behavior of cystosarcoma phyllodes. Analysis of ninety-four cases. Cancer. 1967 Dec;20(12):2090–2099. doi: 10.1002/1097-0142(196712)20:12<2090::aid-cncr2820201206>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  69. OBERMAN H. A. CYSTOSARCOMA PHYLLODES; A CLINICOPATHOLOGIC STUDY OF HYPERCELLULAR PERIDUCTAL STROMAL NEOPLASMS OF BREAST. Cancer. 1965 Jun;18:697–710. doi: 10.1002/1097-0142(196506)18:6<697::aid-cncr2820180607>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  70. Page J. E., Williams J. E. The radiological features of phylloides tumour of the breast with clinico-pathological correlation. Clin Radiol. 1991 Jul;44(1):8–12. doi: 10.1016/s0009-9260(05)80217-x. [DOI] [PubMed] [Google Scholar]
  71. Palmer M. L., De Risi D. C., Pelikan A., Patel J., Nemoto T., Rosner D., Dao T. L. Treatment options and recurrence potential for cystosarcoma phyllodes. Surg Gynecol Obstet. 1990 Mar;170(3):193–196. [PubMed] [Google Scholar]
  72. Pantoja E., Llobet R. E., Lopez E. Gigantic cystosarcoma phyllodes in a man with gynecomastia. Arch Surg. 1976 May;111(5):611–611. doi: 10.1001/archsurg.1976.01360230111026. [DOI] [PubMed] [Google Scholar]
  73. Paulus D. D. Benign diseases of the breast. Radiol Clin North Am. 1983 Mar;21(1):27–50. [PubMed] [Google Scholar]
  74. Pietruszka M., Barnes L. Cystosarcoma phyllodes: a clinicopathologic analysis of 42 cases. Cancer. 1978 May;41(5):1974–1983. doi: 10.1002/1097-0142(197805)41:5<1974::aid-cncr2820410543>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  75. Popescu I., Serbănescu M., Ivăchescu C. Phylloides tumours of the breast. A clinicopathologic study of 19 cases. Zentralbl Chir. 1991;116(5):327–336. [PubMed] [Google Scholar]
  76. Rajan P. B., Cranor M. L., Rosen P. P. Cystosarcoma phyllodes in adolescent girls and young women: a study of 45 patients. Am J Surg Pathol. 1998 Jan;22(1):64–69. doi: 10.1097/00000478-199801000-00008. [DOI] [PubMed] [Google Scholar]
  77. Rao B. R., Meyer J. S., Fry C. G. Most cystosarcoma phyllodes and fibroadenomas have progesterone receptor but lack estrogen receptor: stromal localization of progesterone receptor. Cancer. 1981 Apr 15;47(8):2016–2021. doi: 10.1002/1097-0142(19810415)47:8<2016::aid-cncr2820470819>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  78. Rao C. R., Narasimhamurthy N. K., Jaganathan K., Mukherjee G., Hazarika D. Cystosarcoma phyllodes. Diagnosis by fine needle aspiration cytology. Acta Cytol. 1992 Mar-Apr;36(2):203–207. [PubMed] [Google Scholar]
  79. Reinfuss M., Mituś J., Duda K., Stelmach A., Ryś J., Smolak K. The treatment and prognosis of patients with phyllodes tumor of the breast: an analysis of 170 cases. Cancer. 1996 Mar 1;77(5):910–916. doi: 10.1002/(sici)1097-0142(19960301)77:5<910::aid-cncr16>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  80. Reinfuss M., Mituś J., Smolak K., Stelmach A. Malignant phyllodes tumours of the breast. A clinical and pathological analysis of 55 cases. Eur J Cancer. 1993;29A(9):1252–1256. doi: 10.1016/0959-8049(93)90067-p. [DOI] [PubMed] [Google Scholar]
  81. Rix D. B., Tredwell S. J., Forward A. D. Cystosarcoma phylloides (cellular intracanalicular fibroadenoma): clinical-pathological relationships. Can J Surg. 1971 Jan;14(1):31–37. [PubMed] [Google Scholar]
  82. Rowell M. D., Perry R. R., Hsiu J. G., Barranco S. C. Phyllodes tumors. Am J Surg. 1993 Mar;165(3):376–379. doi: 10.1016/s0002-9610(05)80849-9. [DOI] [PubMed] [Google Scholar]
  83. Salvadori B., Cusumano F., Del Bo R., Delledonne V., Grassi M., Rovini D., Saccozzi R., Andreola S., Clemente C. Surgical treatment of phyllodes tumors of the breast. Cancer. 1989 Jun 15;63(12):2532–2536. doi: 10.1002/1097-0142(19890615)63:12<2532::aid-cncr2820631229>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  84. Sawhney N., Garrahan N., Douglas-Jones A. G., Williams E. D. Epithelial--stromal interactions in tumors. A morphologic study of fibroepithelial tumors of the breast. Cancer. 1992 Oct 15;70(8):2115–2120. doi: 10.1002/1097-0142(19921015)70:8<2115::aid-cncr2820700818>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  85. Shabalova I. P., Chemeris G. J., Ermilova V. D., Rodionova L. M., Pavlikova N. A., Syrjänen K. J. Phyllodes tumour: cytologic and histologic presentation of 22 cases, and immunohistochemical demonstration of p53. Cytopathology. 1997 Jun;8(3):177–187. doi: 10.1046/j.1365-2303.1997.45875458.x. [DOI] [PubMed] [Google Scholar]
  86. Shabb N. S. Phyllodes tumor. Fine needle aspiration cytology of eight cases. Acta Cytol. 1997 Mar-Apr;41(2):321–326. doi: 10.1159/000332519. [DOI] [PubMed] [Google Scholar]
  87. Shimizu K., Masawa N., Yamada T., Okamoto K., Kanda K. Cytologic evaluation of phyllodes tumors as compared to fibroadenomas of the breast. Acta Cytol. 1994 Nov-Dec;38(6):891–897. [PubMed] [Google Scholar]
  88. Simi U., Moretti D., Iacconi P., Arganini M., Roncella M., Miccoli P., Giacomini G. Fine needle aspiration cytopathology of phyllodes tumor. Differential diagnosis with fibroadenoma. Acta Cytol. 1988 Jan-Feb;32(1):63–66. [PubMed] [Google Scholar]
  89. Staren E. D., Lynch G., Boyle C., Witt T. R., Bines S. D. Malignant cystosarcoma phyllodes. Am Surg. 1994 Aug;60(8):583–585. [PubMed] [Google Scholar]
  90. Stebbing J. F., Nash A. G. Diagnosis and management of phyllodes tumour of the breast: experience of 33 cases at a specialist centre. Ann R Coll Surg Engl. 1995 May;77(3):181–184. [PMC free article] [PubMed] [Google Scholar]
  91. Stockdale A. D., Leader M. Phyllodes tumour of the breast: response to radiotherapy. Clin Radiol. 1987 May;38(3):287–287. doi: 10.1016/s0009-9260(87)80071-5. [DOI] [PubMed] [Google Scholar]
  92. TREVES N., SUNDERLAND D. A. Cystosarcoma phyllodes of the breast: a malignant and a benign tumor; a clinicopathological study of seventy-seven cases. Cancer. 1951 Nov;4(6):1286–1332. doi: 10.1002/1097-0142(195111)4:6<1286::aid-cncr2820040614>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  93. Umpleby H. C., Moore I., Royle G. T., Guyer P. B., Taylor I. An evaluation of the preoperative diagnosis and management of cystosarcoma phyllodes. Ann R Coll Surg Engl. 1989 Sep;71(5):285–288. [PMC free article] [PubMed] [Google Scholar]
  94. Vorherr H., Vorherr U. F., Kutvirt D. M., Key C. R. Cystosarcoma phyllodes: epidemiology, pathohistology, pathobiology, diagnosis, therapy, and survival. Arch Gynecol. 1985;236(3):173–181. doi: 10.1007/BF02133961. [DOI] [PubMed] [Google Scholar]
  95. Ward R. M., Evans H. L. Cystosarcoma phyllodes. A clinicopathologic study of 26 cases. Cancer. 1986 Nov 15;58(10):2282–2289. doi: 10.1002/1097-0142(19861115)58:10<2282::aid-cncr2820581021>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  96. West T. L., Weiland L. H., Clagett O. T. Cystosarcoma phyllodes. Ann Surg. 1971 Apr;173(4):520–528. doi: 10.1097/00000658-197104000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  97. Yamashita J., Ogawa M., Egami H., Matsuo S., Kiyohara H., Inada K., Yamashita S., Fujita S. Abundant expression of immunoreactive endothelin 1 in mammary phyllodes tumor: possible paracrine role of endothelin 1 in the growth of stromal cells in phyllodes tumor. Cancer Res. 1992 Jul 15;52(14):4046–4049. [PubMed] [Google Scholar]
  98. Zissis C., Apostolikas N., Konstantinidou A., Griniatsos J., Vassilopoulos P. P. The extent of surgery and prognosis of patients with phyllodes tumor of the breast. Breast Cancer Res Treat. 1998 Apr;48(3):205–210. doi: 10.1023/a:1005980831359. [DOI] [PubMed] [Google Scholar]
  99. Zurrida S., Bartoli C., Galimberti V., Squicciarini P., Delledonne V., Veronesi P., Bono A., de Palo G., Salvadori B. Which therapy for unexpected phyllode tumour of the breast? Eur J Cancer. 1992;28(2-3):654–657. doi: 10.1016/s0959-8049(05)80119-4. [DOI] [PubMed] [Google Scholar]
  100. de Roos W. K., Kaye P., Dent D. M. Factors leading to local recurrence or death after surgical resection of phyllodes tumours of the breast. Br J Surg. 1999 Mar;86(3):396–399. doi: 10.1046/j.1365-2168.1999.01035.x. [DOI] [PubMed] [Google Scholar]
  101. el-Naggar A. K., Ro J. Y., McLemore D., Garnsy L. DNA content and proliferative activity of cystosarcoma phyllodes of the breast. Potential prognostic significance. Am J Clin Pathol. 1990 Apr;93(4):480–485. doi: 10.1093/ajcp/93.4.480. [DOI] [PubMed] [Google Scholar]

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