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Phyllodes Tumor of the Breast: Histopathologic Features, Differential Diagnosis, Accuraсу of preoperative pathological diagnosis in Core Needle Biopsy
Russian Federation (HCCM Russia) - Samara State Medical University, Samara
The department of General and clinical pathology:pathology anatomy and pathology physiology
MD Fedorina Tatyana Aleksandrovna
Dr. Poletaeva Svetlana Vladimirovna
Required: English Accepted: Russian
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
Phyllodes tumor of the breast is a rare fibroepithelial neoplasm with risks of local recurrence and uncommon metastases. The classification proposed by the World Health Organization for PTs into benign, borderline, and malignant is based on a combination of several histologic features. Distant metastasis occurs in up to 22% of malignant type. Accurate preoperative pathological diagnosis allows correct surgical planning and avoidance of reoperation, either to achieve wider excision or for subsequent tumor recurrence. Phyllodes tumor bears specific clinical characteristic and can be considered as a differential diagnosis for the breast lumps. The preoperative diagnosis and proper management are crucial in phyllodes tumor because of their tendency to recur and malignant potential in some of these tumors.
What is the aim of the project?
The aim of the study is to increase the accuracy of the preoperative morphological diagnosis of malignant Phyllodes tumor; assessment of the prognostic role of the histological type of sarcomatous component in malignant Phyllodes tumor. The tasks are set to evaluate the number and distribution of observations of various forms of Phyllodes tumor, to identify the main morphological prognostic factors.
What techniques and methods are used?
The used methods are: cutting surgical material with resected tumor with resection margin marking wit special stains, examination of histological specimens stained with hematoxylin and eosin, immunohistochemical method, quantitative analysis with camera and computer program for getting such parameters as the stromal cellularity, nuclear atypia, mitotic activity, stromal overgrowth, statistical method: adding data in excel tabs and analyzing how that data correlated with frequency of local recurrence and distant metastases. Malignant phyllodes tumour from 18 patients with complete surgical excision or after mastectomy for large tumours in our Oncological Dispensary (from 2008 to 2016), were examinated. Clinical, ultrasound, Computerized Tomography, Magnetic Resonance Imaging dates were retrospective reviewed. Types of sarcomas were identified by International Conference on Harmonization. Deparaffinized sections were additionally stained for CD117, CD10, p53, ki67.
What is the role of the student?
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
The student will be able to help during cutting surgical material with resected tumor with resection margin marking wit special stains, perform this step independently; perform an examination of histological specimens stained with hematoxylin and eosin; use computer program for getting such parameters as the the stromal cellularity, nuclear atypia, mitotic activity, stromal overgrowth; analyze the results of immunohistochemical tests. After combining and elaboration of the received data in tables, student will analyze it and get to correlate it to frequency of local recurrence and distant metastases.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a poster - The student will prepare a scientific report - The student will prepare an abstract
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Basic knowledge of pathology anatomy is obligatorily required. It is highly welcomed if a student had experience of immunohistochemical method before. Basic knowledge of oncopathology will also be very helpful in the project. Subjects passed: pathology, clinical oncology.
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months)
- 1. Lakhani SR; Ellis IO; Schnitt SJ; Tan PH; van de Vijver MJ; eds. World Health Organization Classification of Tumours of the Breast. Lyon; France: IARC; 2012. World Health Organization Classification of Tumours; vol 4.
- 2. Yasir S; Gamez R; Jenkins S; Visscher DW; Nassar A. Significant histologic features differentiating cellular fibroadenoma from phyllodes tumor on core needle biopsy specimens. Am J Clin Pathol. 2014;142(3):362–369.
- 3. Wang F; Jia Y; Tong Z. Comparison of the clinical and prognostic features of primary breast sarcomas and malignant phyllodes tumor. Jpn J Clin Oncol. 2015;45(2):146–152.
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