Projects / Programmes
Phyllodes tumor of the breast. Histological, cytological, immunohistochemical and nuclear texture features in prediction of its biological behavior
| Code |
Science |
Field |
Subfield |
| 3.04.00 |
Medical sciences |
Oncology |
|
| Code |
Science |
Field |
| B200 |
Biomedical sciences |
Cytology, oncology, cancerology |
phyllodes tumor, breast, stromal-epithelial tumor, pathology, immunohistochemistry, nuclear texture features, prognosis
Researchers (12)
Organisations (1)
| no. |
Code |
Research organisation |
City |
Registration number |
No. of publicationsNo. of publications |
| 1. |
0302 |
Institute of Oncology Ljubljana |
Ljubljana |
5055733000 |
15,885 |
Abstract
Phyllodes tumor of the breast is a rare stromal-epithelial tumor and has been traditionally separated into three prognostically important categories: benign, borderline and malignant. The foremost clinical problem in PT is its relatively unpredictable behavior which does not always follow morphological appearances. Numerous morphological features have been proposed to best explain future development of the tumor such as size, stromal cellularity, stromal overgrowth, mitotic count, presence of heterologous elements and state of surgical margins. In addition, some immunohistochemical markers like p53, bcl-2, EGFR, proliferation markers and hormone receptors were studied to better outline prognostic groups in PT. In spite of all efforts, the tumor is still far from being satisfactorily defined. The need for better delineation of its prognostic categories is understood in the light of different surgical approach to different subgroups of this tumor. Moreover, the relationship of this tumor to a more common fibroepithelial tumor of the breast - fibroadenoma is not completely elucidated. The latter is a benign tumor but some cases of it recur and the recurrent tumor may appear as PT. Such an evolution is clearly an example of neoplastic progression and it would be most useful to define any feature which might be predictive of such a development. Besides, the role of epithelial component in both, PT and fibroadenoma has not been satisfactorily explained and the latter may well be involved in the process of neoplastic progression of the other, i.e. stromal component. Many of numerous, older and recent studies of PT have been hampered by a relative small number of cases being studied. In immunohistochemical studies, sometimes only a single or a very small number of markers were used. In our study, we plan to investigate a relatively large number of around 200 cases of PT seen at our institution in the period of 25 years and carefully study their follow-up of at least 5 years. To that effect, we will reexamine histology and cytology of all cases, and analyze a number of immunohistochemical markers such as proliferation markers, p53, bcl-2, EGFR, progesterone and estrogen receptors, CD34, and use TUNEL method for determination of apoptosis. Furthermore, in a representative group of PT we will also employ image cytometrical analysis to determine nuclear texture features what has never been attempted before in PT. We expect that an analysis of combined cytological, histological, immunohistochemical and nuclear texture features on this relatively large number of cases might provide us with some new information that would be useful in prediction of biological behavior of PT. Such information might be also helpful in interpretation of small biopsies like FNAB and core needle biopsy. Additionally, the study may shed some light into intricacies of PT-fibroadenoma relationship.
