Phyllodes tumour of the breast: clinical follow-up of 33 cases of this rare disease.
OBJECTIVE
The "cystosarcoma phyllodes" of the breast is a rare entity which accounts for 0.5% of all breast neoplasms. The aim of our study was to analyse the clinical management with respect to patient outcome.


METHODS
The data of 5270 patients with primary breast neoplasms treated in our department between 1984 and 2005 were retrospectively analysed for the histopathologic diagnosis of a cystosarcoma phyllodes. The clinical data was analysed with respect to tumour grading and size, treatment and prognosis.


RESULTS
Retrospective analysis of 5270 patients with primary breast neoplasms revealed 33 patients. In the histopathological analysis, tumour grade was classified as benign in 40%, borderline in 27% and malignant in 33% of patients. Breast conserving surgery was conducted in 58% of the patients, mastectomy in 42%. Only one patient was treated with adjuvant radiotherapy after primary surgery. Mean tumour size was 6.9 cm, and no lymph node infiltration was found in the 10 patients who received axillary lymph node dissection. Local recurrence occurred in eight patients (26%). The local recurrence rate was 50% in malignant, 20% in borderline and only 8% in benign tumours. Distant metastases were seen in three patients (9%) with malignant phyllodes tumours. Neither regarding age at primary diagnosis nor in tumour size there was a significant difference between patients with local recurrence or metastatic spread and those without (p=0.284 tumour size; p=0.739 for age; Mann-Whitney U-test).


CONCLUSIONS
Histopathological classification appears to be the strongest prognostic factor in this disease.
Lenhard
Miriam S
MS
Department of Obstetrics and Gynecology, University Hospital Munich, Ludwig-Maximilians-University of Munich, Grosshadern, Marchioninistrasse 15, Munich, Germany. Miriam.Lenhard@med.uni-muenchen.de
Kahlert
Steffen
S
Himsl
Isabelle
I
Ditsch
Nina
N
Untch
Michael
M
Bauerfeind
Ingo
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D003557:Phyllodes Tumor / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D035583:Rare Diseases; D012189:Retrospective Studies