Abstract P4-14-14: Phyllodes tumour of the breast: A retrospective analysis of 87 cases

Abstract

Abstract Background: Phyllodes tumour is a rare fibroepithelial tumour of the breast that accounts for only 0.5% of all breast neoplasms. Methods: We retrospectively reviewed the case notes of all patients with phyllodes tumour treated between 1987–2010. Clinical data was analysed with respect to pathological and treatment outcome data. Results: Between 1987–2010, 87 patients were treated for tumours, histologically classified as benign (60), borderline (10) and malignant (17). Median age at presentation was 55 years for patients with malignant phyllodes, 45 years for benign phyllodes and 48 years for patients with borderline tumours. Primary surgery for patients with benign or borderline phyllodes in 68 cases was breast conserving with 2 patients undergoing mastectomy. Of those with malignant phyllodes, primary surgery for 6 patients was mastectomy and 11 patients had breast conserving surgery. 2 patients with malignant phyllodes received adjuvant radiotherapy, to the chest wall for recurrence following mastectomy in one patient and following local excision in the other patient. 2 patients with malignant phyllodes proceeded to axillary surgery, with no involvement of lymph nodes. 6 patients (8.6 %) with benign disease and 4 (23.5 %) with malignant phyllodes had a local recurrence. Of those with malignant phyllodes who had a recurrence, 2 had systemic metastases and all had had a local excision at presentation. Median time to development of metastatic disease from initial presentation was 2.5 years. 1 patient received 1 cycle of palliative doxorubicin but progressed through treatment. Relapse free survival to date for patients with benign, borderline and malignant phyllodes was 91.7 %, 90 % and 70.6 % respectively. Conclusion: Phyllodes tumours form a heterogenous group with a spectrum of behaviour in terms of risk of local recurrence and metastases. From this series, malignant phyllodes have a higher recurrence rate than benign and borderline tumours. Local excision in this group was associated with a 36.4 % local failure rate and 18.2 % risk of systemic metastasis. Treatment for malignant phyllodes should be individually based, but the greater risk of relapse both locally and systemically, should be taken into consideration and the options of mastectomy or oncoplastic techniques considered. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-14-14.