OUP user menu

Phyllodes Tumors of the Breast
The Role of Pathologic Parameters

Puay-Hoon Tan MD, Thiyagarajan Jayabaskar MBBS, Khoon-Leong Chuah FRCPA, Hwei-Yee Lee MBBS, Yen Tan MSc, Maryam Hilmy MSc, Huynh Hung PhD, Sathiyamoorthy Selvarajan MBBS, MSc, Boon-Huat Bay PhD
DOI: http://dx.doi.org/10.1309/U6DVBFM81MLJC1FN 529-540 First published online: 1 April 2005


We aimed to establish whether morphologic parameters were prognostically important in a large series of breast phyllodes tumors in Asian women. Of 335 phyllodes tumors diagnosed at the Department of Pathology, Singapore General Hospital, Singapore, between January 1992 and December 2002, 250 (74.6%) were benign, 54 (16.1%) borderline, and 31 (9.3%) malignant, based on histologic review of archival slides. Of the women, 43 (12.8%) experienced recurrences during the follow-up period. Recurrent disease was correlated with grade or classification (P = .028), stromal atypia (P = .016), stromal hypercellularity (P = .046), and permeative microscopic borders (P = .021). Multivariate analysis revealed that independent predictors of recurrence were pseudoangiomatous stromal hyperplasia (PASH) and margin status, whereby the presence of PASH and complete or negative margins reduced recurrence hazards by 51.3% and 51.7%, respectively. The 7 women who died of disease during follow-up had malignant phyllodes tumor at the outset and experienced recurrences, and death was preceded by distant metastases.

Key Words:
  • Grade
  • Surgical margins
  • Recurrence
  • Pseudoangiomatous stromal hyperplasia