Phyllodes Tumor Of The Breast: Clinical Analysis Of71Cases

Objective: Phyllodes tumor of the breast accounts for about0.3%to1%of thebreast tumor, whose clinical manifestations shows similarity to the common breasttumor. Besides, its preoperative diagnosis is difficult. Therefore, it can easily result inmisdiagnosis. Due to the inconsistency of the biological behavior and histopathologic-al grading of the phyllodes tumor, its clinical manifestations are often difficult to bepredicted with high local recurrence rate after misdiagnosis. Through the analysis of thecharacteristics of phyllodes tumor of the breast in clinical diagnosis and treatment, thispaper attempts to improve the understanding of phyllodes tumor of the breast.Methods: The clinical data of71cases of the First Affiliated Hospital and theSecond Affiliated Hospital of Dalian Medical University with phyllodes tumor of thebreast from May2006to December2012is collected with telephone follow-up for theretrospective analysis and research in combination with the literature.Results: The71cases of patients with phyllodes tumor of the breast are all femaleaged from15to73with a median age of45. The time from onset to treatment isbetween2days to12years with a median duration of1year. Most patients (58/71) seethe doctor taking the single shot painless lump as the initial symptom, whose maximaldiameter of the lump is from1to20cm with10cases≥10cm and an average of5.36cm, and29cases (36.6%) of that are located on the upper outer quadrant.Preoperative B-ultrasound check is done by62patients, of which11cases areconsidered as phyllodes tumor,15cases as breast cancer, and18cases as breastfibroadenoma.The surgical approach is divided into30cases (42.3%) of the local excision of thebreast,15cases (21.1%) of the local expansion excision of the breast, and26cases(36.6%) of the mastectomy. Phyllodes tumor of the breast is diagnosed by postoperativepathological diagnosis, of which30cases (42.3%) are benign,22cases (31.0%) areborderline, and19cases (26.7%) are malignant. The successful follow-up is60cases with the follow-up rate of84.5%(60/71), the follow-up time of6to81months, andmedian follow-up time of38months. A total of14cases of the patients with successfulfollow-up appears local recurrence with the median recurrence time of13months. Itappears recurrence for one case of patient with malignant phyllodes tumor after simplemastectomy, and adjuvant radiotherapy treatment is taken;1case of patient withmalignant phyllodes tumor also take adjuvant radiotherapy treatment after twice localrecurrence. Chi-square test is conducted to the relationship of age, lump size, whetherthere is short-term history of the lump, menstrual status and pathological grading, andthe result of that shows no statistical significance. Chi-square test is conducted to thedifference of local recurrence of the characteristics of clinical features, surgicalapproach and histopathology, and the result of that shows there is statistical significanceof the surgical approach (P=0.019) in the local recurrence. Others are with nostatistical significance.Conclusions: Phyllodes tumor of the breast is a rare breast cancer, whose clinicalmanifestations mainly shows solitary painless lump of the breast. The preoperativemisdiagnosis rate is high, and the definite diagnosis relies on postoperative routinepathological examination. Surgical resection is the primary means for phyllodes tumortherapy. This study shows that statistical significance (P=0.019) exists in thedifference of local recurrence rate by different surgical approaches. The measure oflocal extensive excision of the breast is recommended to taken for patients with benignand borderline phyllodes tumor (to ensure the cutting edge of more than1cm), and themeasure of simple excision of the breast is recommended to taken for patients withmalignant phyllodes tumor or local recurrence and even multiple recurrence.