Management of malignant and borderline phyllodes tumors of the breast: our experience

J BUON. 2019 Jul-Aug;24(4):1521-1525.

Abstract

Purpose: Phyllodes breast tumors (PT) range from benign lesions to malignant ones that may give distant metastasis. Preoperative diagnosis is difficult, while the treatment of borderline and malignant disease remains controversial.

Methods: Eighteen patients in 3 clinics were included in the study. Lumpectomy with large margins was performed in 15 patients, while mastectomy was performed in 3 patients. Lymph node excision was carried out in 3 patients with malignant tumors. Radiation therapy (RT) was delivered after a second lumpectomy in cases of local recurrence. Chemotherapy was used only in 2 patients with aggressive recurrent tumors.

Results: Borderline behavior was reported in 4 patients. Lumpectomy was performed in these cases, with local recurrence in 2 of them. Malignant behavior was reported in 14 patients. Lumpectomy was performed in 10 patients and mastectomy in 3. Local recurrence was reported in 5 cases and in 2 patients recurrence after a 2nd operation was also reported.

Conclusions: Borderline PT were treated conservatively and the prognosis was excellent, while malignant subtypes needed mastectomy in about 25% of the cases, The local recurrence rate was high, but the disease free survival (DFS) and the overall survival (OS) were also very high (94%).

MeSH terms

  • Adult
  • Aged
  • Breast / pathology
  • Breast / surgery
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Lymph Node Excision / methods
  • Margins of Excision
  • Mastectomy
  • Mastectomy, Segmental
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Phyllodes Tumor / pathology
  • Phyllodes Tumor / surgery*
  • Prognosis*