Breast Cancer

, Volume 3, Issue 2, pp 79–92 | Cite as

Phyllodes tumor of the breast: Pathology, histogenesis, diagnosis, and treatment

  • Shinzaburo Noguchi
  • Tomohiko Aihara
  • Kazuyoshi Motomura
  • Hideo Inaji
  • Shingi Imaoka
  • Hiroki Koyama
  • Tsutomu Kasugai
  • Akira Wada
Review Article


Phyllodes tumor of the breast is histologically unique in that it is composed of epithelial and stromal components. The histogenesis of this disease has remained largely unknown but recently we have obtained interesting information through clonal analysis, and have been able to show a difference in the histogenesis between phyllodes tumor and fibroadenoma. Elucidation of histogenesis would definitely improve our understanding of the biological behavior of this disease and also help to establish the most appropriate treatment strategy. The pathology, histogenesis, diagnosis, and treatment of phyllodes tumor are reviewed in this paper. Our hypothesis on the histogenesis of this disease is also presented.

Key words

Phyllodes tumor Fibroadenoma Clonality 



Androgen receptor


Base pairs


Fine needle aspiration biopsy


Polymelase chain reaction




Restriction fragment length polymorphism


Maternal X-chromosome


Paternal X-chromosome


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1).
    Muller J: Uber den feinern Bau und die Formen der Krankhaften Geschwulste, G Reimer, Berlin, 1838.Google Scholar
  2. 2).
    Lee B, Pack G: Giant intracanalicular fibroadenomyxoma of the breast.Am J Cancer 15:2583–2609, 1931.Google Scholar
  3. 3).
    Histologic typing of breast tumours. In: WHO International Histological Classification of Tumours, 2nd ed, World Health Organization, Geneva, 1981.Google Scholar
  4. 4).
    McDaniel MD, Crichlow RW: Cystosarcoma phyllodes. In: Strombek SO, Rosato FE eds, Surgery of the Breast, Thienne Inc, New York, pp151–152, 1986.Google Scholar
  5. 5).
    Haagensen CD: Cystosarcoma phyllodes. In: Haagensen CD ed, Diseases of the Breast, WB Saunders, New York, pp284–312, 1986.Google Scholar
  6. 6).
    Grove A, Kristensen LD: Intraductal carcinoma within a phyllodes tumor of the breast; A case report.Tumori 56:1691–1695, 1985.Google Scholar
  7. 7).
    Treves N, Sunderland DA: Cystosarcoma phyllodes of the breast; A malignant and benign tumor; A clinicopathological study of seventy-seven cases.Cancer 4:1286–1332, 1951.PubMedCrossRefGoogle Scholar
  8. 8).
    Norris HJ, Taylor HB: Relationship of histologic features to behavior of cystosarcoma phyllodes; Analysis of ninety-four cases.Cancer 20:2090–2099, 1967.PubMedCrossRefGoogle Scholar
  9. 9).
    Oberman HA: Cystosarcoma phyllodes; A clinicopathologic study of hypercellular periductal stromal neoplasms of the breast.Cancer 18:697–710, 1965.PubMedCrossRefGoogle Scholar
  10. 10).
    Pietruszka M, Barnes L: Cystosarcoma phyllodes; A clinicopathological analysis of 42 cases.Cancer 41: 1974–1983, 1978.PubMedCrossRefGoogle Scholar
  11. 11).
    Grigioni WF, Santini D, Grassigli A: A clinicopathologic study of cystosarcoma phyllodes; Twenty case reports.Arch Anat Cytol Pathol 30:303–306, 1982.PubMedGoogle Scholar
  12. 12).
    El-Naggar AK, Ro JY, McLemore D,et al: DNA content and proliferative activity of cystosarcoma phyllodes of the breast.Am J Clin Pathol 93:480–485, 1990.PubMedGoogle Scholar
  13. 13).
    Ciatto S, Bonardi R, Cataliotti L,et al: Phyllodes tumor of the breast; A multicenter series of 59 cases.Eur J Surg Oncol 18:545–549, 1992.PubMedGoogle Scholar
  14. 14).
    Grimes MM: Cystosarcoma phyllodes of the breast; Histologic features, flow cytometric analysis, and clinical correlations.Mod Pathol 5:232–239, 1992.PubMedGoogle Scholar
  15. 15).
    Reinfuss M, Mitus J, Smolak K,et al: Malignant phyllodes tumours of the breast; A clinical and pathological analysis of 55 cases.Eur J Cancer 29A:1252- 1256, 1993.PubMedCrossRefGoogle Scholar
  16. 16).
    Hawkins RE, Schofield JB, Fisher C,et al: The clinical and histologic criteria that predict metastases from cystosarcoma phyllodes.Cancer 69:141–147, 1992.PubMedCrossRefGoogle Scholar
  17. 17).
    Kim CJ, Kim WH: Patterns of p53 expression in phyllodes tumors of the breast; An immunohistochemical study.J Korean Med Sci 8:325–328, 1993.PubMedGoogle Scholar
  18. 18).
    Thor AD, Moore II DH, Edgerton SM: Accumulation of p53 tumour suppressor gene protein; An independent marker of prognosis in breast cancer.J Natl Cancer Inst 84:845–855, 1992.PubMedCrossRefGoogle Scholar
  19. 19).
    Dixon JM: Cystic disease and fibroadenoma of the breast; Natural history and relation to breast cancer risk.Br Med Bull 47:258–271, 1991.PubMedGoogle Scholar
  20. 20).
    Noguchi S, Motomura K, Inaji H,et al: Clonal analysis of fibroadenoma and phyllodes tumor of the breast.Cancer Res 53:4071–4074, 1993.PubMedGoogle Scholar
  21. 21).
    Knudson Jr AG: Mutation and human cancer.Adv Cancer Res 17:317–335, 1973.CrossRefGoogle Scholar
  22. 22).
    Fialkow PJ: Clonal origin of human tumors.Biochem Biophisica Acta 458:283–321, 1976.Google Scholar
  23. 23).
    Arnold A, Ataunton CE, Kim HG,et al: Monoclonality and abnormal parathyroid hormone genes in parathyroid adenomas.N Engl J Med 318:658–662, 1988.PubMedGoogle Scholar
  24. 24).
    Vogelstein B, Fearon ER, Hamilton SR,et al: Use of restriction fragment length polymorphism to determine the clonal origin of human tumors.Science 227: 642–645, 1985.PubMedCrossRefGoogle Scholar
  25. 25).
    Gilliland DG, Blanchard KL, Levy J,et al: Clonality in myeloproliferative disorders; Analysis by means of the polymerase chain reaction.Proc Natl Acad Sci USA 88:6848–6852, 1991.PubMedCrossRefGoogle Scholar
  26. 26).
    Miccoli P, Iacconi P, Roncella M,et al: Les tumeurs Phyllodes du sein.Acta Chir Belg 85:128–132, 1985.PubMedGoogle Scholar
  27. 27).
    Noguchi S, Yokouchi H, Aihara T,et al: Demonstration of progression from fibroadenoma to phyllodes tumor of the breast through clonal analysis.Cancer 76:1779–1985, 1995.PubMedCrossRefGoogle Scholar
  28. 28).
    Mashal RD, Lester SC, Sklar J: Clonal analysis by study of X chromosome inactivation in formalin- fixed paraffin-embedded tissue.Cancer Res 53:4676- 4679, 1993.PubMedGoogle Scholar
  29. 29).
    Calabrese G, Virgilio CD, Cianchetti E,et al: Chromosome abnormalities in breast fibroadenomas.Genes Chromosome Cancer 3:202–204, 1991.CrossRefGoogle Scholar
  30. 30).
    Tagliaferri G: Tumore Filloide della mammella.Recenti Progressi in Medicina 75:1006–1033, 1984.PubMedGoogle Scholar
  31. 31).
    Salvadori B, Cusumano F, Del Bo R,et al: Surgical treatment of phyllodes tumors of the breast.Cancer 63:3532–3536, 1989.CrossRefGoogle Scholar
  32. 32).
    Kessinger A, Foley JF, Lemon HM,et al: Metastatic cystosarcoma phyllodes.J Surg Oncol 4:131–147, 1972.PubMedCrossRefGoogle Scholar
  33. 33).
    Stanely MW, Tani EM, Skoog L: Fine-needle aspiration of fibroadenomas of the breast with atypia; A spectrum including cases that cytologically mimic carcinoma.Diagn Cytopathol 6:375–382, 1990.CrossRefGoogle Scholar
  34. 34).
    Lindquist KD, Van Heerden JA, Weiland LH,et al: Recurrent and metastatic cystosarcoma phyllodes.Am J Surg 144:341–343, 1982.PubMedCrossRefGoogle Scholar
  35. 35).
    Contarini O, Urdaneta LF, Hagen W,et al: Cystosarcoma phyllodes of the breast; A new therapeutic proposal.Ann Surg 48:157–166, 1982.Google Scholar
  36. 36).
    Turalba CIC, El-Mahdi AM, Ladaga L: Fatal metastatic cystosarcoma phyllodes in an adolescent female; Case report and review of treatment approaches.J Surg Oncol 33:176–181, 1986.PubMedCrossRefGoogle Scholar
  37. 37).
    Weidner N, Volkman J, Pozza F,et al: Tumor angiogenesis; A new significant and independent prognostic factor in early-stage breast cancer.J Natl Cancer Inst 84:1875–1887, 1992.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 1996

Authors and Affiliations

  • Shinzaburo Noguchi
    • 1
  • Tomohiko Aihara
    • 1
  • Kazuyoshi Motomura
    • 1
  • Hideo Inaji
    • 1
  • Shingi Imaoka
    • 1
  • Hiroki Koyama
    • 1
  • Tsutomu Kasugai
    • 2
  • Akira Wada
    • 2
  1. 1.Departments of SurgeryOsaka Medical Center for Cancer and Cardiovascular DiseasesJapan
  2. 2.Departments of PathologyOsaka Medical Center for Cancer and Cardiovascular DiseasesHigashinari-ku, OsakaJapan

Personalised recommendations