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Ann Diagn Pathol ; 51: 151702, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33472142

ABSTRACT

BACKGROUND: Phyllodes tumor (PT) accounts for <1% of all breast tumors worldwide. Based on their microscopic features, these tumors are classified into benign, borderline, and malignant. This study aimed at evaluating the clinical experience and the clinicopathologic features of PT. METHODS: A retrospective cohort study of 46 female patients with histologically diagnosed PT. Data collection and evaluation was done on patient demographics, preoperative radiological assessment and pathology, surgical procedure, post-surgery pathological evaluation, radiation therapy (RT), and follow-up. RESULTS: The median age at diagnosis was 42 years and young premenopausal patients (median age 35 years) had malignant PT. Forty-five patients underwent core needle biopsy (CNB) with high sensitivity and the positive predictive value (82.2% and 97.4% respectively). Thirty-nine patients (86.7%) underwent conservative surgery and 6 (13.3%) had a mastectomy. Twenty-seven (58.6%) were classified as benign, 11 (23.9%) as borderline and only 8 (17.4%) as malignant PT. Malignant PT had the greatest median tumor size (13 cm). Mortality and recurrence rates were 4.3% and 2.2% respectively. RT was administered in 6 patients (13.0%), 5 having malignant and 1 borderline PT. The metastatic rate was found to be 6.5%. CONCLUSION: PT are rare breast tumors with variable biologic behavior and heterogenous clinicopathological findings. Young, premenopausal women with large tumors may have malignant PT with a risk of recurrence and metastasis. Core needle biopsy is a reliable tool for diagnosis of PT with strict follow-up recommended for large tumors diagnosed as fibroadenoma on CNB. Surgical management must ensure a tumor-free margin on excision to reduce recurrence.


Subject(s)
Biopsy, Large-Core Needle/methods , Breast Neoplasms/pathology , Phyllodes Tumor/diagnosis , Phyllodes Tumor/surgery , Adolescent , Adult , Aged , Female , Fibroadenoma/diagnosis , Fibroadenoma/pathology , Follow-Up Studies , Humans , Margins of Excision , Mastectomy/statistics & numerical data , Middle Aged , Mortality/trends , Neoplasm Metastasis/pathology , Neoplasm Recurrence, Local/epidemiology , Phyllodes Tumor/classification , Phyllodes Tumor/ultrastructure , Predictive Value of Tests , Radiotherapy/methods , Radiotherapy/statistics & numerical data , Retrospective Studies , Saudi Arabia/epidemiology , Tertiary Care Centers , Young Adult
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