TREATMENT MODALITIES OF PHYLLODES TUMORS OF THE BREAST

Abstract

Phyllodes tumor of the breast is a rare fibroepithelial lesion. Between January 1993 and January 2008, 19 patients diagnosed with phyllodes tumor, were retrospectively analyzed in terms of demographic and clinicopathologic features and treatment modalities. The median age was 43 (range, 20-65). For diagnosis, 11 patients underwent excisional biopsy, 4 cases had incisional biopsies, and 4 patients had core biopsies/fine needle aspiration cytology. One patient with T4 tumor and lung metastasis was considered inoperable and received chemotherapy alone. Thirteen patients had breast conservative surgery (lumpectomy or reexcision), whereas 5 patients underwent mastectomy. The median tumor size was 7 cm (range, 2-21 cm). The pathologic classification of the tumors was as follows: benign (n=6, 31.5%), borderline (n=6, 31.5%), and malignant (n=7, 37%). Among those with malignant phyllodes, 2 patients received chemotherapy and radiotherapy followed by mastectomy, and three patients with lumpectomy had radiotherapy. Median follow-up time was 36 months (4-108). One patient with malignant phylloides with mastectomy had lung metastases at the 24th month followed by chemotherapy&radiotherapy, and died of metastatic disease 3 months later. Furthermore, another patient with benign phyllodes who underwent lumpectomy with unknown surgical margins was found to have a local recurrence as benign phyllodes at the 37th month. No other recurrences were noted. The 5-year overall survival of patients with borderline&malign phyllodes was 83%. In conclusion, margin negative surgery plays a major role in the management of patients diagnosed with phyllodes tumors. However, the survival benefit of adjuvant chemotherapy or radiation treatment warrants further investigation.