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Division of Pathology Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1 o’clock breast lump showed a fibroadenoma. Section provided of the 5 o’clock lump.

Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

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Page 1: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

Division of Pathology

Singapore General Hospital

Case 11

27 year old Chinese female.Left breast lumps at 1 o’clock and 5 o’clock.The 1 o’clock breast lump showed a fibroadenoma.Section provided of the 5 o’clock lump.

Page 2: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

Division of Pathology

Singapore General Hospital

Page 3: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

Division of Pathology

Singapore General Hospital

Page 4: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

Division of Pathology

Singapore General Hospital

Page 5: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

Division of Pathology

Singapore General Hospital

Page 6: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

Division of Pathology

Singapore General Hospital

Page 7: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

Division of Pathology

Singapore General Hospital

Additional pictures

Page 8: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

3 x 2.5 x 2.5cm

Page 9: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

ER

Page 10: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

ER

Page 11: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

PR

Page 12: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

CK5/6

Page 13: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

CK14

Page 14: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

Diagnosis, case 11

• Left breast 5 o’clock lump:

Ductal carcinoma in situ, low nuclear grade, without necrosis, within a benign phyllodes tumour.

DCIS is 10mm in size, with ER and PR positivity.

(Abnormal epithelial cytoarchitectural changes observed in 5 tissue blocks)

Division of Pathology

Singapore General Hospital

Page 15: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

J Clin Pathol. 2016 Apr;69(4):364-9. doi: 10.1136/jclinpath-2015-203475.

Breast carcinoma and phyllodes tumour: a case series. Sin EI, Wong CY, Yong WS, Ong KW, Madhukumar P, Tan VK, Thike AA, Tan PH, Tan BK.

▪ Malignant transformation of the epithelial component of phyllodes tumours (PT) is rare and only reported in literature as sporadic cases of carcinoma associated with PTs.

▪ We report the clinicopathological characteristics of in situ and invasive carcinoma coexisting with PT in 10 patients treated in our institution over an 11-year period from 1992 to 2012.

▪ Ten patients with coexisting PT and in situ or invasive carcinoma were identified from our records.

▪ Six had carcinoma found within the PT.

▪ All were female with a median age of 47 (43-72) years.

▪ One patient had a history of PT in the same breast while another had a history of PT in the same breast as well as invasive ductal carcinoma in the contralateral breast.

▪ The rest did not have any risk factors of breast cancer.

Division of Pathology

Singapore General Hospital

Page 16: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

J Clin Pathol. 2016 Apr;69(4):364-9. doi: 10.1136/jclinpath-2015-203475.

Breast carcinoma and phyllodes tumour: a case series. Sin EI, Wong CY, Yong WS, Ong KW, Madhukumar P, Tan VK, Thike AA, Tan PH, Tan BK.

▪ Five patients had a preoperative core needle biopsy performed with the report of a fibroepithelial lesion.

▪ The rest of the patients had surgery upfront for their breast masses.

▪ Two patients who had ER/PR positive invasive carcinoma received adjuvant hormonal therapy.

▪ Patients were followed up for a mean of 3.6 years (9 months-10 years) and all patients were alive and recurrence free.

▪ PT associated with carcinoma is rare, and we present a series of cases that add to the limited current literature.

▪ It is often difficult to detect the presence of the carcinomatous component preoperatively.

▪ Hence, close examination of resected PT specimens must be carried out to allow prompt detection of any associated carcinomas, however rare, such that adequate treatment can be given.

Division of Pathology

Singapore General Hospital

Page 17: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

J Clin Pathol. 2016 Apr;69(4):364-9

Division of Pathology

Singapore General Hospital

Page 18: Singapore General Hospital - Case 25 69 year old female ......Singapore General Hospital Case 11 27 year old Chinese female. Left breast lumps at 1 o’clock and 5 o’clock. The 1

Division of Pathology

Singapore General Hospital

Thank You


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