Phyllodes Breast Tumors: A Review of a Single Saudi Institution Experience

Introduction: Phyllodes tumors (PT) are rare fibroepithelial neoplasms, accounting for less than 0.5% of all primary breast tumors. This study aims to evaluate the local recurrence, distant metastasis, mortality and overall... [ view full abstract ]

Introduction: Phyllodes tumors (PT) are rare fibroepithelial neoplasms, accounting for less than 0.5% of all primary breast tumors. This study aims to evaluate the local recurrence, distant metastasis, mortality and overall survival rates of PT cases.

Methods:  A retrospective analysis of the clinical, pathological, and therapeutic data of 45 patients with a PT who were treated between January 2000 and December 2015 at a single Saudi institution. Tumors were classified into benign (21 cases), borderline (6 cases), and malignant (18 cases) according to the criteria proposed by the World Health Organization "WHO".

Results: The median follow-up period was 35 (7-185 months). The median age was 37 (19-62 years). The median tumor size was 9.2 (2.3-25cm). Surgery consisted of wide local excision in 27 cases (60%), simple mastectomy in 14 cases (31.1%), and nipple-sparing mastectomy in 4 cases (8.9%). The surgical margins were positive in 12 cases (26.7%). While, the overall rate of local recurrence for the entire group was 8.9% (4 cases), it was 4.7% (1 case) for benign PT, and 16.6% (3 cases) for malignant PT. Distant metastasis developed in 6 patients with malignant PT; thus the distant metastasis rate was 13.3% for the entire group and 33.3% for the group with malignant PT. There were 2 mortality cases among those affected with malignant PT. Therefore, the mortality rate was 4.4% for the entire group and 11.1% for the group with malignant PT.

Conclusion: Our experience suggests that adequate surgery with negative margins is the treatment of choice.