モリヤ　タクヤ   Takuya Moriya   森谷　卓也    所属   川崎医科大学  医学部    職種   学長付特任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Malignant phyllodes tumours of the breast: the case for revising WHO's 'full house' diagnostic criteria.
掲載誌名	正式名：Histopathology 略　 称：Histopathology ISSNコード：13652559/03090167
掲載区分	国外
国際共著	国際共著
著者・共著者	Puay Hoon Tan, Ian O Ellis, Kimberly H Allison, Sunil S Badve, Edi Brogi, Grace Callagy, Emmanuelle Charafe-Jauffret, Chih-Jung Chen, Yunn-Yi Chen, Laura C Collins, Gábor Cserni, Lounes Djerroudi, Maria Pia Foschini, Stephen B Fox, Helenice Gobbi, Mihir Gudi, Oi Harada, Shabnam Jaffer, Janina Kulka, Hajime Kuroda, Sunil R Lakhani, Xiaoxian Li, Takuya Moriya, Sandra O'Toole, Sarah E Pinder, Elena Provenzano, Cecily Quinn, Wendy Raymond, Aysegul A Sahin, Fernando Schmitt, Abeer M Shaaban, Tanuja Shet, Kalliopi P Siziopikou, Ping Tang, Gary M Tse, Zsuzsanna Varga, Anne Vincent-Salomon, Hannah Wen, Rin Yamaguchi, Wentao Yang, Stuart J Schnitt, Emad A Rakha
発行年月	2025/04
概要	Phyllodes tumours (PTs) of the breast present diagnostic challenges due to their complex histological features and potential for malignant behaviour. The World Health Organisation (WHO) classification requires the presence of five adverse histological criteria to categorise PTs as malignant, aiming to avoid overdiagnosis and improve diagnostic consistency. However, emerging evidence suggests that these strict criteria may underdiagnose tumours with metastatic potential and histological features that would otherwise be considered malignant in soft tissue tumours, leading to significant implications for prognosis and treatment. Recent studies have highlighted cases where tumours classified as borderline PT by WHO criteria exhibited metastatic behaviour, emphasising the need to refine the diagnostic framework. Microscopic criteria used to classify PT also vary among reporting pathologists, resulting in suboptimal reproducibility. This review examines the histological parameters utilised in the classification of malignant PT, highlights existing evidence gaps and analyses international breast pathologist survey data to propose a pragmatic diagnostic approach. We recommend redefining malignant PTs to include cases meeting four of the five WHO criteria, supplemented by comprehensive sampling and clinical context. This approach balances the risk of underdiagnosis with the need for standardised, reproducible diagnostic practices. Future collaborative efforts should focus upon developing evidence-based, biologically relevant classification systems and leveraging technological advancements to enhance diagnostic precision. These efforts aim to refine classification, improve prognostic accuracy and optimise patient management strategies.
DOI	10.1111/his.15455
PMID	40223225