Phyllodes tumors of the breast : analysis of 35 cases from a single institution

Abstract EN

Background : Phyllodes tumors are rare fibroepithelial breast tumors with diverse biological behavior.

Our study aim is to review the clinico-pathological features, prognostic factors and treatment outcome for patients presenting with phyllodes tumors of the breast to the Kuwait Cancer Control Center (KCCC).

Patients and methods : We retrospectively reviewed the clinical and pathological data of 35 women of histologically proved phyllodes tumors of the breast retrieved between January 1994 and December 2012.

Results : The median age was 40 years (21–63 years).

The median pathological tumor size was 6.8 cm (3–25 cm).

Histologically, one patient (3 %) presented with benign, 13 (37 %) with borderline and 21 (60 %) with malignant phyllodes.

Twenty-eight patients (80 %) were premenopausal.

Twenty (57 %) were ultimately treated with mastectomy (3 borderline, and 17 malignant) and 15 (43 %) with conservative surgery (1 benign, 10 borderline and 4 malignant).

Axillary staging was carried out in 9 patients (1 borderline and 8 malignant), none of them had nodal metastasis.

Four patients with malignant phyllodes received postoperative radiotherapy.

After a median follow-up period of 52 months (range 5–211 months), 5 developed local recurrence (1 benign, 2 borderline and 2 malignant).

One patient with malignant phyllodes developed distant lung metastasis.

The overall 5-year relapse free survival (RFS) was 74% (68 % for borderline and 84% for malignant phyllodes).

According to the treatment modality, the 5-year RFS was 69% for conservative surgery compared to 87% for mastectomy.

It was 100% for irradiated patients versus 71% for non irradiated patients.

Conclusion : Phyllodes tumors are rare tumors that occur in relatively young women, when compared with the classical adenocarcinoma of the breast.

They have a tendency to reach large sizes with absence of nodal metastasis.

Although surgery is the mainstay of management, postoperative radiotherapy also appears to decrease the local recurrence rates in certain presentations.