Management of phyllodes tumour of breast: 5 year experience at Madina Teaching Hospital, Faisalabad.

Abstract

Objectives: To determine the oncological outcome of different types of phyllodes tumour (PT) and to analyze the impact of radiotherapy on outcome. Study Design: Experimental study. Setting: Madina Teaching Hospital, Faisalabad, Pakistan. Period: April 2015 to April 2020. Material & Methods: Female patients diagnosed as phyllodes tumour of breast were included and classified into benign, borderline and malignant PT according to WHO criteria. Borderline and malignant PT were further divided into 2 groups; Group A (Surgery alone) and Group B (Surgery + Radiotherapy). Oncological outcome based on local recurrence, distant metastasis and overall survival rate among different types of phyllodes tumour and those patients who received or not received radiotherapy was assessed. Results: In 5 years, 29 patients of phyllodes tumour were studied. 15 (51.7%) patients had benign, 8 (27.6%) malignant and 6 (20.7%) borderline tumour. Mean age of our patients was 39.5 years (range: 25-55 years).The disease free survival rate was 82.8% (100% for benign, 83.4% for borderline and 50% for malignant PT). Malignant histotype and tumour size >6cm were significantly associated with recurrence (p<0.05). In Group A, 4 patients developed local recurrence and 2 of them developed distant metastasis; while in group B only 1 patients developed local recurrence (p=0.2, OR=0.147). Overall survival rate was 93.1%. It was 100% for radiotherapy group compared to 88% for non irradiated patients. Conclusion: Malignant phyllodes tumour and large tumour size is associated with worse prognosis. Post operative radiotherapy is associated with improved local recurrence, distant metastasis and overall survival.