Factors Affecting Local Recurrence for Phyllodes Tumors of the Breast: a Retrospective Analysis of 89 Patients in a Single Center

Abstract

The local recurrence (LR) of phyllodes tumor (PT) of the breast has a clinical importance as it may result in sarcomatous degeneration. The aim of this study was to identify factors affecting LR in patients with PT of the breast. We retrospectively investigated 89 patients with PT who underwent surgical treatment from 2008 to 2014. The predictive role of age, number of tumors, type of surgery, tumor size, tumor histology, stromal cellularity, cellular pleomorphism, stromal overgrowth, mitosis count, resection margin status, and extent of resection margin on LR were analyzed. The median follow-up time was 42 months (range, 10–84 months) and the median patient age was 34 years (range, 15–80 years). The numbers of patients with benign, borderline, and malignant PTs were 68 (76%), 14 (16%), and 7 (8%), respectively. The median tumor size was 3.0 cm (range, 1–13 cm). A total of 85 patients (95%) underwent local or wide excisions while mastectomy was performed in 4 patients (5%). LR occurred in 12 patients (13.5%) and one patient with malignant PT died due to distant metastasis. Positive margin status was the only independent predictor of LR in multivariable model (hazard ratio, 7.5; 95% confidence interval, 3.1–22.5; p = 0.001). Other factors including extent of tumor-free resection margin had not significant effect on LR. Effective local control of disease may be achieved through a negative resection margin. The contribution of wider surgical margins to reduce LR can be questioned by larger studies.