title: Phyllodes tumor of the breast: a retrospective study of the impact of histopathological factors in local recurrence and distant metastasis.
abstract: OBJECTIVE
  The challenging issue for the breast surgeons is local recurrence of phyllodes tumor. The histological criteria to predict local recurrence has been a controversial issue. The objective of this study was to determine pathological parameters and surgical margins that influence outcome of local recurrence and distant metastasis in phyllodes tumor (PT).
  
  
  METHODS
  Retrospective review between January 2003 to August 2008 at King Hussein Cancer Center-Jordan.
  
  
  METHODS
  Forty-two female patients diagnosed as having PT were classified to benign, borderline and malignant. The medical records were reviewed in relation to the surgical management, recurrence, follow-up, the histological features of the tumor and grading of tumors based on the following histological parameters: mitotic count, stromal cellularity, stromal overgrowth, cellular pleomorphism, nuclear grade, tumor necrosis, tumor margin, and surgical margin status. All patients underwent wide local excision of the tumor or mastectomy.
  
  
  RESULTS
  Forty-two patients with PT (16 benign, 9 borderline, 17 malignant PT) were followed up for 30 months. The mean age was 39.8 years, and the average tumor size was 6.6 cm. The recurrence rate of PT in our study was 21% at a mean time of 11 months. Nine patients had local recurrence; 2 benign, 6 malignant and 1 borderline. Cellular pleomorphism had correlation with recurrence rate (P=.045). We had six patients (14%) with distant metastasis. All had malignant PT. Metastasis in PT has a relationship with histological grade (P=.02).
  
  
  CONCLUSIONS
  We conclude that patients with moderate and severe cellular pleomorphism had higher local recurrence, while metastatic PT occur more in patients with high nuclear grade.
authors.affiliation: Department of Surgery- College of Medicine, Taibah University, Al-Madinah 30001, Saudi Arabia. drsawalhi@yahoo.com
authors.forename: Samer
authors.initials: S
authors.lastname: Sawalhi
authors.forename: Marwa
authors.initials: M
authors.lastname: Al-Shatti
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D003557:Phyllodes Tumor / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
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