Mitoses counting in phyllodes tumours: rationale for a standardized hotspot-based approach
- Journal
- Histopathology (Q1)
- Published
- 8 October 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Edward Hadi, Mihir Gudi, Bill Li, Sandra O'Toole, Ales Ryska, Gary Tse, et al.
- PMID
- 42847547
- DOI
- 10.1111/his.70293
Why clinicians should know about it
- Picked for Pathology and Forensic Medicine (paper of the day, 11 October 2026): Standardized mitoses counting in phyllodes tumours
Abstract
BACKGROUND: Breast phyllodes tumours (PTs) are rare biphasic fibroepithelial neoplasms, classified into benign, borderline and malignant categories. Stromal mitotic activity is a key criterion in grading PT, but the methodology for mitotic assessment has not been clearly articulated. MATERIALS AND METHODS: We discuss the approach to determining stromal mitotic activity in PTs. Whether the most mitotically active area (hotspot) or an average count across several tumour regions should be adopted is reviewed. We also outline the operational protocol for mitotic hotspot evaluation, accounting for different microscope models with varying field diameters. RESULTS: A standardized method of determining stromal mitoses in PTs is recommended in order to improve interobserver reproducibility and accuracy in grading PTs. The application of digital tools in stromal mitotic counting is also addressed. CONCLUSION: We advocate using the hotspot method of obtaining the highest stromal mitotic count, together with other histological parameters, to classify PTs.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.