Phyllodes tumour of the breast: Clinical follow-up of 33 cases of this rare disease
ABSTRACT The "cystosarcoma phyllodes" of the breast is a rare entity which accounts for 0.5% of all breast neoplasms. The aim of our study was to analyse the clinical management with respect to patient outcome.
The data of 5270 patients with primary breast neoplasms treated in our department between 1984 and 2005 were retrospectively analysed for the histopathologic diagnosis of a cystosarcoma phyllodes. The clinical data was analysed with respect to tumour grading and size, treatment and prognosis.
Retrospective analysis of 5270 patients with primary breast neoplasms revealed 33 patients. In the histopathological analysis, tumour grade was classified as benign in 40%, borderline in 27% and malignant in 33% of patients. Breast conserving surgery was conducted in 58% of the patients, mastectomy in 42%. Only one patient was treated with adjuvant radiotherapy after primary surgery. Mean tumour size was 6.9 cm, and no lymph node infiltration was found in the 10 patients who received axillary lymph node dissection. Local recurrence occurred in eight patients (26%). The local recurrence rate was 50% in malignant, 20% in borderline and only 8% in benign tumours. Distant metastases were seen in three patients (9%) with malignant phyllodes tumours. Neither regarding age at primary diagnosis nor in tumour size there was a significant difference between patients with local recurrence or metastatic spread and those without (p=0.284 tumour size; p=0.739 for age; Mann-Whitney U-test).
Histopathological classification appears to be the strongest prognostic factor in this disease.
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ABSTRACT: Objectives: Phyllodes tumours (PT) are rare neoplasms accounting for less than 1% of breast lesions. With increased breast awareness and screening programmes, smaller PTs are being detected. The purpose of this study was to determine the clinical, radiological and pathological presentation of PT and to evaluate the role of imaging follow up, for which there are no specific guidelines. Methods: A retrospective study of all patients diagnosed with PT in a symptomatic unit between January 2006 and March 2013 was carried out. Patients were identified using Breast Care and Electronic Patient Record Databases. Results: 53 patients with 54 lesions were diagnosed as having a PT. Median age was 27.5, 35 and 38.5 years for benign, borderline and malignant PT respectively. Borderline and malignant PTs were larger than benign PTs, with mean sizes of 33mm and 42mm compared to 29mm. 38% of PTs were labelled by the reporting radiologist as fibroadenomas including 2 borderline and 1 malignant PT. In 24 % of cases the radiologist raised the possibility of PT in the report. 17 patients (40%) developed a new fibroepithelial breast lesion during follow-up of which 4 were recurrent PT. Conclusion: Despite adequate surgical management, development of further fibroepithelial lesions in the ipsilateral breast is common. Three year clinical surveillance, with the addition of 6-monthly ultrasound is advised for women with initial borderline or malignant PT histology. Advances in knowledge: We propose a follow-up protocol with ultrasound based on the grade of the PT diagnosed for 3 years to detect recurrence.British Journal of Radiology 10/2014; 87(1044):20140239. DOI:10.1259/bjr.20140239 · 1.53 Impact Factor
Canadian family physician Medecin de famille canadien 02/2014; 60(2):142-6. · 1.40 Impact Factor
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ABSTRACT: Phyllodes tumor is an extremely rare tumor of the breast. It occurs in females in the third and fourth decades. The difficulty in distinguishing between phyllodes tumors and benign fibroadenoma may lead to misdiagnosis. Lymph node involvement is rarely described in phyllodes tumors; for this reason, sentinel node biopsy may be warranted. We present a case of a 33-year-old woman affected by huge tumor of the right breast with ulceration in the skin with a rapid tumor growth and with omolateral axillary metastasis.World Journal of Surgical Oncology 12/2015; 13(1):508. DOI:10.1186/s12957-015-0508-7 · 1.20 Impact Factor