Malignant phylliodes tumours: Results of breast conserving surgery and immediate reconstruction

ABSTRACT

Malignant phylliodes tumour [MPT] is a rare breast tumor. Surgery is the mainstay in treatment but varies from local resection to modified radical mastectomy. In this study, we present our experience using wide local excision or subcutaneous mastectomy and immediate breast reconstruction in the management of MPT. Twenty-three recurrent MPT and ten patients with histological evidence of MPT were included. All patients with recurrent MPT [n=23] had subcutaneous mastectomy, two centimeter wide excision of the scar and immediate breast reconstruction with either Latissimus Dorsi [LD] myocutaneous flap [n= 10] or Latissimus Dorsi muscle flap [n=13]. Seven of the newly diagnosed patients had wide local excision of the tumor, reconstruction with LD muscle flap, two had wide local excision and reduction of contra lateral breast, and one had subcutaneous mastectomy and silicon implant. The margin resection varied between five and fifteen centimeter in wide local resection group and subcutaneous mastectomy group respectively and the size of tumors varied between five and fifteen centimeters in diameter. During the follow up period, which ranged between twenty-four and eighty-four months one local recurrence, was recorded [3.03%] and none of the patients had distant metastasis or regional lymph nodes involvement. This approach has secured wider excision of MPT, offered breast reconstruction, and has reduced the chances of recurrence in our patients