Phyllodes Tumor of the Breast
Grading / Staging / Report
Grading
- Adverse features
- Stromal overgrowth (> one 40x field without epithelium)
- High mitotic index (>10 /10 hpf)
- Sarcomatous stroma (stromal nuclear pleomorphism and atypia)
- Infiltrative margin
- Benign
- No adverse features
- 20% recurrence rate after local excision
- 10% recurrence rate after wide excision (at least 1 cm margin)
- No reported metastases
- Borderline
- One or more adverse features but short of definition for malignant (see below)
- 45% recurrence rate after local excision
- 30% recurrence rate after wide excision (at least 1 cm margin)
- No reported metastases
- Malignant
- High mitotic index and sarcomatous stroma OR
- Stroma overgrowth and either high mitotic index or sarcomatous stroma
- 65% recurrence rate after local excision
- 35% recurrence rate after wide excision (at least 1 cm margin)
- 30% metastatic rate
Staging
- Not applicable
Report
- Grade
- Size
- Margin status
- Presence and type of heterologous differentiation
