Carcinoma arising within phyllodes tumors of the breast: clinicopathologic observation and a literature review of five cases

Objective: Cases of phyllodes tumors (PTs) of the breast with a malignant epithelial component are rare. The pathogenesis and optimal treatment of patients with carcinoma within PT are still not clear. Methods: We collected five cases of carcinoma arising within PT of the breast between 2007 and 2018, and performed morphological observations and immunohistochemistry using the EnVision method. Results: Four cases arose from benign PT, including two cases of low-grade ductal carcinoma in situ (DCIS), and two cases from classical lobular carcinoma in situ (LCIS). One case with squamous cell carcinoma (SCC) arose from malignant PT. Immunohistochemistry revealed that the LCIS and DCIS cases were diffusely positive for ER and PR, while the single case of SCC was negative. After 15–64 months of follow-up, all patients were alive. Conclusion:To date, there has been no standard treatment for this disease. Thorough sampling is needed to avoid a missed diagnosis. Sentinel lymph node biopsy should be performed if invasive cancer is present.

Phyllodes tumor; Breast carcinoma; Pathology; Differential diagnosis

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