Phyllodes Tumors Of The Breast:Clincal Study Of32Cases And A Review Of The Literatures

Background and objective:Phyllodes Tumors are rare fibroepithelial neoplasms of the breast and accounts for1% of all breast tumors. Phyllodes Tumors have a clinical manifestation similar to benign tumor, so it is easy to misdiagnose before operation. No typic morphologic finding is reliable in predicting the clinical behavior of the tumor. In order to improve the understanding of phyllodes tumors, we investigated the clinicopathologic feature, diagnosis, surgical approach and prognostic factors of phyllodes tumors in this study.Methods:We collected the records of32patients with phyllodes tumor from The First Affiliated Hospital of Zhejiang University from Sep.2007to Jan.2012. All patients were followed up after operation. Then we reviewed the related literatures, and retrospectively analyzed the data. Results:All32patients were female. The mean age was44.5years (range23-73). Most patients presented breast mass without pain. The majority of tumors were found in the upper outer quadrant (46.9%) of breast. The initial surgical approach is mainly breast conserving surgery, including local excision (46.9%) and wide local excision (40.6%). The pathologic diagnoses included16benign,10borderline, and6malignant lesions. The mean follow-up was30.1months (range6-54).5patients (15.6%) had a local recurrence and no any patient died. After breast conserving surgery,8.33%,22.2%,40% of patients with benign, borderline, and malignant phyllodes tumors, respectively, recurred in the breast. Histologic features in local recurrence:4cases had stromal overgrowth,3caes had mitotic activity, and the average size of tumor is4.2cm.1case presented the skin nodules after recurrence and was underwent mastectomy and postoperative adjuvant radiation therapy.Conclusions:Patients with phyllodes tumors usually present painless breast mass without characteristic clinical manifestation. The rate of comformation is low before surgery. Surgical margin, stromal overgrowth, and mitotic activity are correlated with recurrence. Margin-negative resction is critical therapy for benign and borderline and simple mastectomy for the malignant phyllodes tumors of the breast are acceptable surgical options.