Phyllodes tumors in African American women
Phyllodes tumors in African American women
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DOI：
10.1016/j.amjsurg.2014.09.040
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发表时间：
2015-07-01
影响因子：
3
通讯作者：
Okoli, Joel
中科院分区：
文献类型：
--
作者：
Bumpers, Harvey L.;Tadros, Talaat;Okoli, Joel
背景：叶状肿瘤是一种罕见的肿瘤，仅占所有乳腺肿瘤的不到1%。定义恶性叶状病变 (MP) 临床预测因素的研究很少且不一致。此外，从未对非裔美国 (AA) 女性 MP 的发生率进行过分析。本研究将描述 AA 患者的临床和病理特征，这些特征可以合理预测恶性肿瘤的可能性。方法：对 1982 年至 2012 年间诊断为叶状肿瘤（PT）并接受治疗的 50 例 AA 患者的临床记录进行回顾性研究。对患者的人口统计、病理结果和治疗进行分析。结果：40 例被诊断为良性疾病。 (78%)，3 例 (6%) 处于临界状态，7 例 (14%) 患者为恶性肿瘤；然而，1 名患者 (2%) 患有混合叶状导管原位癌。良性疾病患者的平均年龄 (33 岁) 与恶性肿瘤患者的平均年龄 (54 岁；P < .001) 存在显着差异。平均肿瘤大小是原来的两倍（11.8 vs 4.1 cm；P = 0.029），有丝分裂更高，50% 的 MP 每 10 个高倍视野中有超过 5 个。虽然罕见，但淋巴结转移、溃疡和多中心病变仅发生在 MP 中。结论：在患有叶状肿瘤的 AA 患者中，恶性肿瘤患者比良性疾病患者年龄更大、肿瘤更大、有丝分裂指数更高。 AA 患者还表现出一些较罕见的晚期疾病特征，并且出现接近报告最高频率的恶性肿瘤。 (C) 2015 Elsevier Inc. 保留所有权利。
BACKGROUND: Phyllodes is a rare tumor accounting for less than 1% of all breast neoplasms. Studies defining clinical predictors of malignant phyllodes (MP) are rare and inconsistent. Furthermore, MP occurrence in African American (AA) women has never been analyzed. This study will delineate clinical and pathologic features in AA patients that may reasonably predict the probability of malignancy.METHODS: A retrospective study of clinical records was carried out for 50 AA patients diagnosed with phyllodes tumors (PT) and treated between 1982 and 2012. Patients' charts were analyzed regarding demographics, pathology findings, and treatment.RESULTS: The diagnosis of benign disease was made in 40 (78%), borderline in 3 (6%), and malignancy in 7 (14%) patients; however, 1 patient (2%) had mixed phyllodes with ductal carcinoma in situ. The mean age was significantly different for patients with benign disease (33 years) compared with those with malignancy (54 years; P < .001). The average tumor size was twice as large (11.8 vs 4.1 cm; P = .029) and mitoses were higher with 50% of MPs having greater than 5 per 10 high power fields. Although rare, nodal metastasis, ulceration, and multicentric disease occurred only in MP.CONCLUSIONS: Among AA patients with phyllodes tumors, those with malignant tumors were older and had larger tumors and higher mitotic indices than those with benign disease. AA patients also displayed some of the more rare features of advanced disease and presented with malignancy near the highest reported frequency. (C) 2015 Elsevier Inc. All rights reserved.