Phyllodes tumors of breast treated in a single tertiary center: A prospective study

Abstract

Background: Phyllodes tumors (PT) are rare biphasic tumors occurring exclusively in breast tissue. Due to their various biological behavior and clinical presentation, they have potency for recurrence and progression to malignancy. Hence, it has created trouble in preoperative diagnosis. Aims and Objectives: The aim of the study was to study and analyze the clinical, histopathological findings, modalities of treatment, and outcomes of treatment, i.e., recurrence and survival of patients with late complications. Materials and Methods: A prospective case series study was done during the period of January 2020–December 2022 (2 years) in the Department of General Surgery, VIMSAR BURLA, ODISHA. A total of 42 patients were diagnosed with PT clinically, by ultrasonography and mammography and fine-needle aspiration cytology excluding the cases with recurrent PTs. They were undergone various type of surgical procedures and followed up for outcomes such as recurrences and late complications. Results: The average age during diagnosis was 42 years (range: 20–66 years). Out of 42 cases, 33 (78.6%) were benign, 5 (11.9%) were borderline, and 4 (9.5%) were malignant. Tumor size varies from 3 cm to 13 cm with average size of 6.38 cm. A patient with PT of size 28 cm was identified as an exception in our study. Patients with right side tumors were 19 and left side were 21, and 2 patients were having involvement of breast bilaterally. These patients were followed up for 6 to 24-month period. 6 (14.2%) patients reported with recurrence and reoperated again for that. 5 patients lost follow-up (probably cured) and 2 patients died due to malignant metastasis. Conclusion: Phyllodes tumor has specific clinical characteristics and can be considered one of the differential diagnoses of breast lumps. Preoperative diagnosis and proper treatment by checking clear surgical margins play a critical role in preventing recurrence of PT. Grading of PTs pathologically is essential to predict the risk of recurrence, and survival rate as its biological behavior is unpredictable. In this study, our observations provide perception into the clinical, histopathological findings, treatment modalities, and surgical outcomes, i.e., recurrence and prognosis of PT in this geographical region.