Phyllodes Tumors of the Breast: Clinicopathological Analysis of 35 Single-Center Cases

Abstract

Aim: This study was conducted with the aim of to evaluate demographics of patients with phyllodes tumor (PT), clinical and histopathologic characteristics of tumors, and to share treatment approach to PTs from the experience of our center. Method: In the study, the demographic, clinicopathological characteristics and treatment approaches of the patients who were treated between 2006 and 2017 at the Oncology Institute, Istanbul University with the diagnosis of PT were evaluated retrospectively by examining the patient files and pathology records. Results: The median age was 39.7±11.1 years. For diagnosis, 6 patients underwent excisional biopsies, 1 patient incisional biopsy, and 27 patients core biopsies. Twenty seven patients underwent breast-conserving surgery (BCS), whereas 8 patients had mastectomy. Re-excision was added to one lumpectomy, and 2 cases who had BCS were converted to mastectomy due to margin positivity. The mean PT size was 55.3 mm (13 mm - 210 mm). The PT subtypes were as follows: benign (n=15, 42.9%), borderline (n=7, 20.0%), and malignant (n=13, 37.1%). Among those with malignant PTs, 3 patients received chemotherapy (CT) and radiotherapy (RT) following mastectomy, one patient with lumpectomy had CT and RT, and 2 patients received only RT. Patients with PT were followed for an average of 70 months (12 months- 184 months). Seven local recurrences (LR) (2 benign PT, 1 borderline PT, and 4 malignant PT), 1 single distant metastasis (malignant PT), and 1 LR plus distant metastasis (malignant PT) were observed in follow-up. Conclusion: Negative surgical margin of ≥1cm is the most important step in the management of PTs. The survival benefit of adjuvant CT or RT are contraversial and need further investigation.