Diagnostic Approach to Soft Tissue Tumour of the Breast and Phyllodes Tumour in Ilorin, North Central with Review of Institutional Experience

Abstract

Background: Primary soft tissue tumour (primary mesenchymal tumour) of the breast comprised of spectrum of neoplasm that arise from mammary stroma with comparable tumour biology of primary mesenchymal tumour at other sites. There are palpable diagnostic challenges which can be resolved by considering histomorphologic analysis that characterized each tumour entity regardless of the site and the use immunohistochemical markers. Methodology: This is an analytical hospital based retrospective study of patients with primary breast mesenchymal tumour and phyllodes diagnosed during 2014–2019 at the Department of Pathology, University of Ilorin Teaching Hospital. The histopathological diagnosis of primary mesenchymal tumour of the breast and phyllodes tumours with documented age and other inclusion criteria were used for the study but excluded patients with incomplete information. Result: This study analysed 39 patients with histological diagnosis of soft tissue tumour of the breast and phyllodes. The youngest patients was found to be 16 years of age while the oldest patients was 70 years with the mean age of 37.82±12.86. Benign phyllodes tumour accounted for 19 (48.7%), followed by borderline phyllodes 3 (7.7%) and 1 case of malignant phyllodes. Fibrosarcoma is the most common primary mesenchymal tumour of the breast which accounted for 6 (15.4%), followed by undifferentiated pleomorphic sarcoma 3 (7.7%) and 1 (2.5%) case of the following tumours, Neurofibroma, Granular cell tumour, Myofibroblastoma, Dermatofibroma, Low grade fibromyxoid sarcoma, Rhabdomyosarcoma and, Malignant phyllodes and Angiosarcoma. Conclusion: Primary mesenchymal tumour of the breast are rare or underdiagnosed, biopsy must be interpreted with caution in order to rule out their mimics that is phyllodes and metaplastic carcinoma with histomorphological analysis and complementary ancillary test.