Phyllodes Tumors of the Breast: A Review of 26 Cases

Abstract

BackgroundPhyllodes tumors of the breast are rare and locally aggressive neoplasms. Our study aimed to report the experience of the Farhat Hached Hospital (Sousse, Tunisia) acquired during a 7-year period and to give an additional review of the available literature.MethodsThe authors analyzed retrospectively clinical, radiological, histopathological and therapeutic features as well as outcome in a series of 26 cases diagnosed as phyllodes tumors of the breast at the Pathology Department of Farhat Hached Hospital, Sousse, Tunisia, from 2003 to 2009. The slides were reviewed in order to classify the tumors into benign, borderline and malignant on the basis of the criteria proposed by the World Health Organization.ResultsAll the cases occurred in women. The analysis of this series showed the following characteristics: mean age at diagnosis was 40 years (19 - 66), tumor size was 1.5 - 40 cm (mean: 7.8 cm); the chief complaint was a mammary mass; the right breast was affected in 14 cases, the upper outer quadrant was the most commonly involved site (42.3%); surgical treatment was used in all cases, 21 patients (80.8%) were treated conservatively (13 benign, 6 borderline, and 2 malignant) and 5 (19.2%) by radical surgery (1 borderline and 4 malignant); seven patients underwent post-operative radiotherapy; in 14/19 cases (73.7%), a good correlation was observed between intraoperative frozen section analysis and definitive histology; the tumor was classed as benign in 13 cases (50%), borderline in 7 cases (27%) and malignant in 6 cases (23%); follow-up data was available in 22 cases; the rate of recurrence was 23% (1 benign, 3 borderline, and 2 malignant) after a mean follow-up of 13.6 months; all the recurrent tumors were initially treated by lumpectomy and were close to margin at the initial pathologic examination; the treatment of recurrences consisted of simple mastectomy in 5 cases, and local excision in one case; three patients developed metastases, one of whom after recurrence; three patients have died.ConclusionsThis is a substantial single institution experience of a rare tumor. Phyllodes tumors of the breast have an unpredictable outcome, thus a wide local excision, with an adequate margin of normal breast tissue, is the preferred initial therapy.

Phyllodes Tumor in a Lactating Breast

“…Previous studies indicated occurrence of phyllodes tumors during pregnancy or lactation as benign, borderline or malignant, and unilateral or bilateral in 14 cases. 1,4–16 The findings of the present case of benign phyllodes tumor with lactational changes is concurrent with a case described previously by Likhitmaskul et al 1 in a 36-year-old pregnant woman who underwent mastectomy 3 weeks postpartum. Generally, phyllodes tumor presents as a relatively circumscribed painless mass.…”

“…summary of case reports of Phyllodes tumor occurring during pregnancy/lactation 1,[4][5][6][7][8][9][10][11][12][13][14][15][16]. …”

Risk Factors for Disease Recurrence in Women With Phyllodes Tumors of the Breast in Southern Colombia: A Nine-Year Cohort Study

“…However, the surgical approach has been based on histological features, the tumor-to-mammary-gland ratio, and patient desire for breast preservation, indicating that recurrence risk is biased by an aggressive surgical approach relative to the differential risk of disease recurrence. Compromised resection margins have also been linked to local and distant recurrence [14][15][16][17]. However, these rates were lower in our study than in previous reports [2,3,8].…”

Malignant Phyllodes Tumor of the Breast with Metastasis to the Pancreas: A Case Report and Review of Literature

“…On mammography, PTs are seen as well-circumscribed round or oval-shaped lobulated masses which on occasion could contain some calcifications [ 5 , 6 ]. On sonography, they appear as well-defined solid masses with heterogenous internal echos, with no posterior acoustic attenuation [ 7 ]. If a solid mass containing clefts or elongated fluid-filled spaces is seen on sonography, PT should be considered.…”