Malignant cystosarcoma phyllodes: a review of the clinical experience at King Faisal specialist hospital and research centre

ABSTRACT

Twelve females with cystosarcoma phyllodes of the breast were referred to King Faisal Specialist Hospital and Research Centre [KFSH and RC] between 1980 and 1990, representing 0.8% of breast cancer patients seen during this period. Median age was 45 years [range 16 to 65 years]. Seven patients [58%] were premenopausal. All patients presented with breast mass, which measured >10 cm in 58% of them. The median duration of symptoms was 15 months [range two to 174]. Neither axillary lymph nodes nor distant metastases were seen at presentation. Surgery was the cornerstone of primary treatment [wide local excision in three and mastectomy in nine]. Two patients received adjuvant chemotherapy and locoregional irradiation. All patients had malignant tumors histologically. Of the four tumors assayed for hormonal receptors, one was positive for estrogen and progesterone receptors. At a median follow-up of 17 months [range two to 77] four patients had relapsed; one died at 19 months and the projected five year survival is 83%. This limited data supports the observation that malignant cystosarcoma phyllodes is a distinctive clinicopathological entity of female breast cancer with a different natural history from carcinoma of the breast. Our survival results are similar to reported experience from the literature