Phyllodes Tumors of the Breast (the Egyptian Experience)

Abstract

Phyllodes tumors (PT) are rare fibroepithelial lesions, about 0.3-0.5% of all breast tumors. This study is an evaluation of patient characteristics, clinicopathologic features, diagnostic tools, therapeutic options, risk factors for recurrence, and distant metastasis and follow-up findings in patients with PTs. One hundred twenty-seven patients with pathologically proved PTs in the National Cancer Institute, Cairo University, Egypt, from January 2011 to January 2016 were reviewed and analyzed. Sixty patients presented with benign PTs (47.2%), 34 had borderline PTs (26.8%), and 33 had malignant PTs (26%). The mean follow-up period was approximately 36 months; local recurrence occurred in 34 patients, 9 benign cases (14.5%), 11 borderlines (32.4%), and 14 malignant PTs (42.4%). Mastectomy was the most commonly used surgery in recurrent cases (61.4%). Axillary staging was performed in 31 cases (24.4%); only 2 cases showed positive nodal metastasis (6.5%) and were of the malignant subtype. Distant metastasis occurred in 12 patients, 4 with borderline PTs, and 8 with malignant PTs. The most common site for metastasis was the lungs and bones. Adjuvant radiotherapy was applied in 9 patients, 2 in borderline phyllodes, and 7 in malignant phyllodes; post-radiotherapy recurrence occurred in 5 malignant phyllodes patients. Chemotherapy was employed in 10 metastatic patients (4 with borderline and 6 with malignant phyllodes); excision with clear margins is important to reduce the local recurrence. Routine axillary staging should not be done. The adjuvant radiation therapy is still controversial. Local recurrence can develop even after appropriate surgery. Therefore, close follow-up is mandatory.

Clinico-Pathological Factors Determining Recurrence of Phyllodes Tumors of the Breast: The 25-Year Experience at a Tertiary Cancer Centre

“…In a study by Ibreaheem et al, adjuvant RT was administered to nine patients, two with borderline PTs and seven with malignant PTs. However, after radiation therapy, five of these patients relapsed, all of whom had malignant PTs [ 26 ]. Kim et al used a large population database known as SEER (Surveillance, Epidemiology, and End Results Program) to investigate the impact of the use of adjuvant RT in malignant PTs on cancer-specific survival (CSS).…”

Kiss Flaps to Repair Large Skin Defect After Excision of Giant Malignant Phyllodes Tumor of the Breast: A Case Report and Literature Review

“…The tumors rarely spread via the lymphatic system and axillary lymph node metastasis rate is < 5%. Therefore, axillary lymph node dissection is unnecessary, yet the removal of suspicious axillary lymph nodes is recommended [17,18]. In this case, axillary lymph node biopsy was carried out because some lymph nodes were found adjacent to the tumor during surgery.…”

Phyllodes tumor in an adolescent female

“…The most common clinical presentation is a large solitary, unilateral breast mass, often found incidentally by the patient herself. 2 The tumor has an average diameter of 4 to 5 cm. These are fast growing tumors and can reach a median size of 4 cm and sometimes can grow up to 50 cm.…”