Affiliations: [a] Department of Breast Surgery, Breast Health Unit, Mater Misericordiae University Hospital, Dublin, Ireland | [b] Department of Breast Radiology, Breast Health Unit, Mater Misericordiae University Hospital, Dublin, Ireland
Correspondence:
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Corresponding author: Siun M. Walsh, Department of Breast Surgery, Breast Health Unit, Mater Misericordiae University Hospital, Dublin, Ireland. E-mail: siunwalsh@mater.ie
Abstract: INTRODUCTION:Phyllodes tumours represent 0.3–1% of breast tumours, typically presenting in women aged 35–55 years. They are classified into benign, borderline and malignant grades and exhibit a spectrum of features. There is significant debate surrounding the optimal management of phyllodes tumour, particularly regarding appropriate margins. METHODS:This is a retrospective review of a prospectively maintained database of patients who underwent surgical management for phyllodes tumours in a single tertiary referral centre from 2007–2017. Patient demographics, tumour characteristics, surgical treatment and follow-up data were analysed. Tumour margins were classified as positive (0 mm), close (≤2 mm) and clear (>2 mm). RESULTS:A total of 57 patients underwent surgical excision of a phyllodes tumour. The Mean age was 37.7 years (range: ages 14–91) with mean follow-up of 38.5 months (range: 0.5–133 months). There were 44 (77%) benign, 4 (7%) borderline and 9 (16%) malignant phyllodes cases. 54 patients had breast conserving surgery (BCS) and 3 underwent mastectomy. 30 (53%) patients underwent re-excision of margins. The final margin status was clear in 32 (56%), close in 13 (23%) and positive in 12 (21%). During follow-up, 4 patients were diagnosed with local recurrence (2 malignant, 1 borderline and 1 benign pathology on recurrence samples). CONCLUSION:There are no clear guidelines for the surgical management and follow-up of phyllodes tumours. This study suggests that patients with malignant phyllodes and positive margins are more likely to develop local recurrence. There is a need for large prospective studies to guide the development of future guidelines.
Keywords: Phyllodes tumour, breast cancer risk, surgical outcomes
DOI: 10.3233/BD-201059
Journal: Breast Disease, vol. 40, no. 3, pp. 171-176, 2021
