Phyllodes tumor of the breast—not all are self-detected

Abstract

Background: Asymptomatic cases of phyllodes tumor (PT) are extremely rare. The objective of the study was to describe the radiological features and to identify clinical differences between asymptomatic and symptomatic patients with PT in a Mexican population. Methods: A retrospective study was conducted including only surgically treated patients. Asymptomatic and symptomatic cases were compared. Descriptive statistical techniques were used. Radiological features were reported in asymptomatic cases. Results: Over 10 years, 305 women with PT were included (307 tumors). The 25 (8.1%) asymptomatic patients were 6 years older than symptomatic patients (47.6 vs . 41.2 years; P=0.005), with more pregnancies (3 vs . 2; P=0.013), more breastfeeding (80% vs . 61%; P=0.042), with smaller tumor size in radiological, and pathology studies (P vs . 68%; P=0.005), and more benign PT (88%). Mammographic images in asymptomatic cases showed a nodule, mostly isodense, and with well-circumscribed margins. Ultrasound (US) demonstrated macrolobular nodules, with hypoechoic pattern and well-circumscribed margins. Percutaneous core-needle biopsies reported 45.5% as PT in asymptomatic cases. Conclusions: As we expected, asymptomatic PTs were smaller than symptomatic cases. Even asymptomatic PT was not to high suspicious nodules in older patients, we recommend excisional biopsy because radiological features are indistinguishable from those of fibroadenomas, and the only <50% were reported as PT with percutaneous needle biopsy.