Clinical Features And Prognosis Of Phyllodes Tumor Of The Breast

Objective :To date,phyllodes tumor of the breast,s diagnosis,treatment and prognostic factors are in dispute.Our article analyzed phyllodes tumor of the breast,s clinical features and prognostic factors to investigate phyllodes tumor of the breast,s preoperative diagnosis,treatment and prognosis.Method: We collected clinical features and prognosis of the patients who diagnosed phyllodes tumor of the breast and treated at the first hospital affiliated to Nanchang University from January 2007 to October 2019.We used Chi-square to analyze the difference of prognosis among all factors,P < 0.05 was considered statistically significant.Result: There were 90 cases who were diagnosed phyllodes tumor of the breast and treated at our hospital from January 2007 to October 2019.We successfully followed up 83 cases with a follow-up rate of 92.2%.83 cases include 61(73.5%)benign phyllodes tumor of the breast,16(19.3%)borderline phyllodes tumor of the breast,6(7.2%)malignant phyllodes tumor of the breast.The mean age of onset was38.8±12.1 years and the mean size of the tumor was 4.9±3.8cm.The first symptom of69 patients(83.1%)was a painless single mass with a median course of 2 months(6days to 5 years).Ultrasound was performed in 79 patients before surgery,and 18(22.8%)patients were considered as phyllodes tumor of the breast,48 patients received preoperative pathological examination,and 33(65.9%)were considered as phyllodes tumor of the breast.All patients received surgery.11 patients(13.3%)underwent ultrasound-guide vacuum-assisted excision with negative surgical margin,51 patients(61.4%)underwent segmental mastectomy with negative margin between 1 to 10 mm.10patients(12.0%)underwent wide local excision,11 patients(13.3%)underwent mastectomy,they all having negative margin more than 10 mm.No patient received postoperative adjuvant therapy.After a median follow-up of 53 months(2-108 months),5 patients(6.0%)experienced local recurrence at the site of initial onset.Among the 5 patients suffered local recurrence,3 patients after segmental mastectomy,1 patient after wide local excision,1 patient after mastectomy,3 patients with negative margin between 1 to 10 mm,2 patients with negative margin more than 10 mm respectively.We performed statistical analysis to identify the differences among patients’ age,tumor size,surgical methods,surgical margins,and pathological types in local recurrence rate.It was found that the difference of local recurrence rate between the two groups with different size tumor was statistically significant(P=0.04),and the others were not statistically significant.Conclusion: The clinical manifestations of phyllodes tumor of the breast are mainly painless single tumor,and its preoperative diagnosis accuracy is low.Surgery remains the cornerstone of treatment for phyllodes tumor of the breast patient,and there is no statistical difference in the prognosis of different surgical margins,so we suggested negative surgical margin for benign and borderline phyllodes tumor of the breast.Tumor more than 5 cm is likely to relapse.