Clinicopathologic Characteristics and Patient Outcomes of Phyllodes Tumors: A Single Institution Experience

Am Surg. 2021 Dec;87(10):1533-1538. doi: 10.1177/00031348211051673. Epub 2021 Oct 23.

Abstract

Phyllodes tumors (PT) are rare fibroepithelial neoplasms that are classified as benign, borderline, or malignant. Patients with PT diagnosed between 2009 and 2019 were identified from a prospectively maintained single institutional database. 76 patients with PT were included; 47 (61.8%) were benign, 9 (11.8%) were borderline, and 20 (26.3%) were malignant. The mean age at diagnosis was 52. Surgical treatment of benign PT included excisional biopsy in 31 (66.0%) patients, segmental mastectomy in 15 (31.9%), and mastectomy in 1 (2.1%). Among patients with borderline PT, operative management was excisional biopsy in 4 (44.4%) and segmental mastectomy in 5 (55.6%). Of those with malignant PT, 7 (35.0%) were treated with excisional biopsy alone, 9 (45.0%) had lumpectomy (segmental mastectomy), and 4 (20.0%) underwent mastectomy. Malignant PT had a higher rate of necrosis compared to borderline or benign PT (25.0% vs 0% vs 4.3%, P = .016). Four patients had recurrent PT. Final positive margins were associated with recurrence (P = .044). The median overall follow-up time was 86.3 months (range 1.5-1414.1 months), and no deaths occurred among patients with malignant PT. Overall, recurrence rates of PT are low but may be increased by presence of positive margins.

Keywords: breast cancer; phyllodes tumor.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Large-Core Needle
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Female
  • Humans
  • Margins of Excision
  • Mastectomy / methods
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Phyllodes Tumor / mortality
  • Phyllodes Tumor / pathology*
  • Phyllodes Tumor / surgery
  • Retrospective Studies
  • Survival Rate