Phyllodes tumour of Breast: Ki 67 expression in various histological subtypes

  • Deepak Kumar B
  • Padma Priya K
  • Sandhyalakshmi B N
  • Srinivasamurthy .
Keywords: phylloides, boderline, malignant, Ki 67, histopathology


Background: Phyllodes tumours [PT] are uncommon fibroepithelial tumours with marked stromal proliferation over epithelial component with majority being benign.Along with grade, additional study of proliferative markers such as p 53,Ki 67  are essential to identify those with potential for aggressive behaviour.In this background study was undertaken to asses the histopathological characters and correlate  Ki 67 expression in different subtypes of PT. Methods: A total of 21 cases were studied.Clinical details, gross features and primary histologic features were taken into consideration. Immunostaining for Ki 67 were performed. Ki 67 immunoexpression was categorised as 0-10, 11-30, 31 and above depending on the percentage of positive tumor cells in each case. Ki 67 immunoexpression was correlated with histologic grade and clinical features. Result: 14 cases (66.7%) of Benign,  03 cases (14.3 %) of borderline, and  04 cases (19 % ) cases of malignant phylloides tumor were seen. Average Ki 67 expression in BPT and BlPT was 4.5 % (range 1-8%) and 14 % (range 13-15 % ) respectively. MPT exhibited Ki range of 41-80 % with average LI of 56 %. A significant association was seen between expression of  Ki 67 in different grades of phyllodes tumour.  Conclusion: Inclusion of Ki 67 in routine histopathology reporting of phylloides is mandatory as Ki LI proves to be of paramount importance in sub categorisation of phylloides.

Author Biography

Associate professor,Department of pathology


1. Chan YJ, Chen BF, Chang CL, Yang TL, Fan CC. Expression of p53 Protein and ki 67 Antigen in Phylloides Tumor of the Breast. J Chin Med Assoc 2004;67:3-8.
2. Khurshid A, Kayani N, Bhurgri Y. Phylloides Tumors in Adoloscent Girls and Young Women in Pakistan. Asian Pacific J Cancer Prev. 7:563-566.
3. Esposito NN, Mohan D, Bruhky A, Lin Y, Kapali M, Dablo DJ. Phyllodes Tumor. A Clinicopathologic and Immunohistochemical Study of 30 cases. Arch Pathol Lab Med. 2006;130:1516-21.
4. Parker SJ, Harries SA. Phyllodes Tumors. Postgrad Med J 2001;77:428-35.
5. Carter D, Schnitt SJ, Mills RR. The Breast. In: Carter D, Greenson JK, Reuter VE, Stoler MH, Mills SE, Sternberg’s Diagnostic Surgical pathology. 5th ed. Philadelphia: Lippincott Williams and Wilkins:2010, The Breast;285-350.
6. Abdelkrim SB, Trabelsi A, Bouzrara M, Boudagga MZ, Memmi A, Bakir DA, Mokni M. Phyllodes tumors of the Breast: A review of 26 cases. World Journal of Oncology 2010,1(3):129-34.
7. Lester SC. The Breast. In: Kumar V, Abbas AK, Fausto N, Aster JC,editors.
Robbins and Cotran Pathologic Basis of Disease. 8th ed. India.Elseivier India Pvt Ltd;2010.
8. Tavassoli FA, Devilee P, editors. World Health Organization of Tumors.
Pathology and Genetics of Tumors of the Breast and Female Genital Organs. Lyon: IARC Press; 2003.
9. Rosen PP. Rosen’s Breast Pathology. 3th ed. Philadelphia: Lippincott William and Wilkins; 2009.
10. Kuruk U, Bayol U, Pala EE, Cumureu S. Importance of P53, Ki-67 expression in the differential diagnosis of benign/malignant phyllodes tumors of the breast. Indian J Pathol and Microbiol 2013; 56(2): 129-34.
11. Rosai J. Rosai and Ackerman’s Surgical Pathology. 10th ed. New Delhi: Reed
Elsevier India Private Limited; 2011. Chapter 20, Breast;1659-1770.
12. Stamatakos M, Tsaknaki S, Kontzoglou K, Gogas J, Kostakis A. Safioleas. Phyllodes tumor of the breast: a rare neoplasm, though not that innocent. Internal Seminars in Surgical Oncology. 2009.
13. Eroglu E. Irkkan C, Bulak H, Kilicoglu B, Oral S. Phyllodes tumor of the breast: case series of 40 patients. Gazi Medical journal 2003;14:29-34.
14. Ahmed S, Rahman MA, Murshed KM, Shirin L. Phyllodes Tumor of Breast: BSMMU Experience. J Bangladesh CollPhySurg 2007;2570-72.
15. Vani BR, Kumar BD, Sandhyalakshmi B N, Geethamala K, Murthy V S, Radha M. Malignant phyllodes tumor with osteoclastic giant cells. Saudi J Health Sci 2014;3:124-6.
16. Gatalica Z, Finkelstein S, Lucio E, Tawfik O, Palazzo J, Hightower B et al.p 53 protein expression and gene mutation in phyllodestumour of the breast.Pathol Res Pract 2001;197:183-7.
Original Article