Diagnosis and Treatment of Phyllode Tumor of Breast / 解放军医学杂志

ABSTRACT

Objective To study the histopathological features, diagnosis criteria, the relationship of surgery pattern and prognosis of phyllode tumor of breast. Methods To analyze the histopathological features and clinical outcome of different surgery patterns in 203 patients with phyllode tumor of breast by Chi square test, Cluster, Focater, Logistic and Cox multivariate regression according to the request of SPSS 10. 0. Results 203 patients with phyllode tumor of breast were divided into three groups, i.e. benign 133 cases, borderline 42 cases and malignant 28 cases. Local recurrences in three groups were 28, 19 and 18, respectively. The patients died from tumor were 0, 2 and 16, and circulatory metastases were 0, 1 and 10, respectively. Five-year survival were 100 %,92. 0% and 33. 3% in the three groups of 131 patients by a 5 years' follow-up survey. Conclusions Tumor necrosis has important value in the diagnosis of phyllode tumor. Nature of tumor margin, cellular pleomorphism, frequency of mitoses and tumor necrosis were statistically appropriate composition in histological diagnosis of phyllode tumor. Wide local excision is preferred for the benign and borderline phyllode tumor, while simple mastectomy is indicated for recurred borderline and malignant, but tylectomy should be abolished in the treatment of phyllode tumor. Correlation of histotypes of phyllode tumor with local recurrence and tumor death was statistically significant at a level of P＜0. 001; correlation of infiltrative growth of the tumor with local recurrence was statistically significant at a level of P＜0. 001. Tumor necrosis and mitotic activity were independent prognostic factors.