Clinicopathologic Spectrum, Management and Outcomes of Phyllodes Tumors of the Breast

Hani Sher Muhammad, Irfan Ali, Mariyah Anwer, Shabina Jaffar, Muhammad Naeem, Hira Moosa

Abstract

Objective:

To assess the clinicopathological features, operative intervention, and survival in patients presenting with phyllodes tumors of breast.  

Study design:

Retrospective observational study.

Place and duration of the study:

Department of General Surgery Ward 3, Jinnah Postgraduate Medical Centre (JPMC) Karachi, from January 2015 to July 2024.

Methods:

All patients diagnosed clinically with features suggestive of phyllodes tumors on radiology and subsequently proven on histopathology were included. Demographics features, characteristics of the tumor, histological subtypes, surgical treatment provided and outcomes were noted. IBM SPSS version 26.0 was used for data entry and analysis.

Results:

Eighty-one patients were treated during the study period. The median age of the patients 46.5 years (from 18 – 83-years), and 75.3% were aged ≥ 40 years. A family history of breast carcinoma was found in 16% of the patients. Lumpectomy (44.4%), wide excision (30.9%), and mastectomy (22.2%) were the surgical procedures performed. Tumors measuring 5-cm were detected in 53.1% of the patients. Local recurrence was noted in 14 (17.3%) patients and was significantly associated with large tumor size, while the association with surgical margin status did not reach statistical significance (p=0.074). In three cases of malignancies, bone metastasis and death were documented. These patients were treated with palliative radiotherapy. None of the patients received chemotherapy.

Conclusion:

 Phyllodes tumors are less common mostly benign lesions. A tumor margin-negative excision is possible in many patients.

Key words:

Phyllodes tumor, Breast neoplasm, Tumor recurrence, Histopathology, Borderline phyllodes, Malignant phyllodes.