How to approach phyllodes tumors of the breast?

Abstract

Objective: Phyllodes tumor of the breast is a rare fibroepithelial breast tumor that comprise 0.3-0.9% of primary breast neoplasms. In this study, we aimed to present clinicopathologic symptoms of our patients along with their treatment modality. Material and Methods:Clinicopathologic properties and treatment modality of 20 phyllodes tumor patients who underwent surgery between January 2008 and January 2013 were retrospectively evaluated.Results: Median patient age was 47 years (22-75). Fine-needle aspiration biopsy was applied to 19 patients. Biopsy results were reported as suspicious in four, malignant in three, benign in 11, and as non-diagnostic in one patient. Final histopathology reports revealed two benign, one malignant and one borderline tumor out of the four patients with suspicious findings on fine needle aspiration biopsy; all patients with malignant cytology had malignancy. There were two borderline and nine benign lesions within the benign biopsy group. Sixteen patients underwent segmental mastectomy, four patients underwent mastectomy with/without axillary dissection. The median tumor size was 6 (1-13) cm. Histopathologically, 11 (55%) tumors were benign, 5 (25%) were borderline, and 4 (20%) were malignant. Two of the four patients with malignancy underwent radiotherapy and chemotherapy, and one patient only received chemotherapy as adjuvant treatment.Conclusion: Phyllodes tumors are rare, mix-type breast tumors. Due to high rates of local recurrence and potential for malignancy, preoperative diagnosis and accurate management are important.

Phyllodes Tumor of the Breast: Analysis of 48 Patients

“…The sonographic and mammographic findings were parallel to the literature; no specific radiologic feature was identified to differentiate the histologic subtypes of PTs. In addition, FA was the most commonly reported radiologic diagnosis with both US and MG, consistent with previous works (15)(16)(17). In recent years, several studies regarding the potential role of magnetic resonance imaging (MRI) in the diagnosis of PT have been published.…”

“…Consequently, sufficient surgical margin is of great importance to minimize the risk of local recurrence. Distant metastasis can be seen in 10% of cases, which most often affects the lungs and bones (17). In our case series, distant metastasis was detected in only one patient with malignant PT, 16 months after surgery.…”

Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors

“…The common treatment of PT is surgical resection, which includes local excision and wide local excision. Local excision is defined as excision with a 5-mm safe surgical margin, and wide local excision is defined as excision with at least 1-cm surgical margin [ 12 ]. A previous study showed no significant difference between the two types of excisions in the recurrence of benign PT [ 13 ].…”

Tumor Filóides Borderline: Relato de caso

“…Desde que essas condições sejam aplicadas, a cirurgia conservadora da mama é o tratamento de escolha. 17,3 A mastectomia simples é recomendada, caso as margens não possam ser garantidas na cirurgia conservadora, pois a retirada inadequada pode levar a recorrência. 13 A mastectomia também é realizada em casos onde os tumores são muito volumosos, maiores que 5 cm, e que comprometem toda a glândula mamária, pode ser realizado também uma adenomastectomia com reconstrução plástica imediata.…”

“…Normalmente os tumores malignos se disseminam através da via hematogênica. 17 Terapias adjuvantes com uso de radioterapia, quimioterapia, ou ambos, ainda não têm um papel claro e definido no tratamento do Tumor Filóides, existindo resultados contraditórios na literatura. 3 Radioterapia adjuvante, por exemplo, é uma questão incerta, alguns estudos mostram que não há melhora no prognóstico, e outros mostram um controle local melhor.…”