title: Phyllodes tumors in African American women.
abstract: 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.
authors: Department of Surgery, College of Human Medicine, Michigan State University, 1200 E. Michigan Avenue, Suite 655, Lansing, MI 48912, USA. Electronic address: harvey.bumpers@hc.msu.edu.
authors: Harvey L
authors: HL
authors: Bumpers
authors: Department of Pathology Emory University School of Medicine, Atlanta, GA, USA; Avon Breast Center, Grady Memorial Hospital, Atlanta, GA, USA.
authors: Talaat
authors: T
authors: Tadros
authors: Avon Breast Center, Grady Memorial Hospital, Atlanta, GA, USA; Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
authors: Sheryl
authors: S
authors: Gabram-Mendola
authors: Avon Breast Center, Grady Memorial Hospital, Atlanta, GA, USA; Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
authors: Monica
authors: M
authors: Rizzo
authors: Department of Surgery, College of Human Medicine, Michigan State University, 1200 E. Michigan Avenue, Suite 655, Lansing, MI 48912, USA.
authors: Mersadies
authors: M
authors: Martin
authors: Department of Surgery, College of Human Medicine, Michigan State University, 1200 E. Michigan Avenue, Suite 655, Lansing, MI 48912, USA.
authors: Nicole
authors: N
authors: Zaremba
authors: Avon Breast Center, Grady Memorial Hospital, Atlanta, GA, USA; Department of Surgery, Morehouse School of Medicine, Atlanta, GA, USA.
authors: Joel
authors: J
authors: Okoli
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D003557:Phyllodes Tumor / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies
keywords: Breast tumors; Cystosarcoma; Phyllodes