Journal of Cytology
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Year : 1999  |  Volume : 16  |  Issue : 2  |  Page : 67-73

Is cytology reliable for diagnosis and subclassification of phyllodes tumour?

1 Consultant Pathologist, Department of Pathology, Tata Memorial Centre, Mumbai, India
2 Oncopathofogy Trainee, Department of Pathology, Tata Memorial Centre, Mumbai, India

Correspondence Address:
Roshni F Chinoy
Consultant Pathologist, Department of Pathology, Tata Memorial Hospital, 8th Floor, Annexe Building, Dr. Ernest Borges Road, Parel, Mumbai 400 012
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Source of Support: None, Conflict of Interest: None

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This is a comparative study of the cytology and histology of 30 phyllodes tumours of the breast, accrued from the Tata Memorial Hospital records. The purpose of this study was to assess the reliability of cytogenetic features when categorizing phyllodes tumours into various sub-types. A needle aspiration performed in all cases was followed by definitive surgery. The aspirates were scored for ceilularity, epithelial stromal ratio, presence of stromal fragments, stromal ceilularity andatypia, mitosis, vascularity and presence of miscellaneous cells. Cytologic evaluation was done without knowledge of the histologic sub-type. Histologically, 22 benign, 4 borderline, 2 malignant phyllodes and 2 stromal sarcomas were identified. A correct cytologic diagnosis was possible in 16 of 22 benign (73%), 1 of 4 borderline (25%), 2 of 2 malignant phyllodes (100%) and in 2 of 2 stromal sarcomas (100%). Stromal fragments were conspicuously present in all cases. Stromal ceilularity andatypia correlated with increasing grade of malignancy. Sentinel cells were present in benign phyllodes but were notably absent In all malignant phyllodes. Vascularity was conspicuously present in malignancy. In conclusion, cytology is reliable in differentiating frankly benign from overtly malignant phyllodes tumour. This information is of immense value in deciding the treatment. The transition between borderline phyllodes and low grade malignancy is difficult or at times impossible. It can be improved with multiple passes to ensure adequate sampling and due consideration to clinical data.

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