title: Radiotherapy in Phyllodes Tumour.
abstract: BACKGROUND
  Phyllodes Tumour (PT) of the breast is a relatively rare breast neoplasm (<1%) with diverse range of pathology and biological behaviour.
  
  
  OBJECTIVE
  To describe the clinical course of PT and to define the role of Radiotherapy (RT) in PT of the breast.
  
  
  METHODS
  Retrospective analysis of hospital data of patients with PT presented from 2005 to 2014 was done. Descriptive statistics was used to analyze the results. Simple description of data was done in this study. Age and duration of symptoms were expressed in median and range. Percentages, tables and general discussions were used to understand the meaning of the data analyzed.
  
  
  RESULTS
  Out of the 98 patients, 92 were eligible for analysis. The median age of presentation was 43 years. A total of 64/92 patients were premenopausal. There was no side predilection for this tumour but 57/92 patients presented as an upper outer quadrant lump. Fifty percent of the patients presented as giant (10 cm) PT. The median duration of symptoms was 12 months (range: 1-168 months). A 60% of patients had Benign (B), 23% had Borderline (BL) and 17% had malignant (M) tumours. The surgical treatment for benign histology included Lumpectomy (L) for 15%, Wide Local Excision (WLE) for 48%, and Simple Mastectomy (SM) for 37%. All BL and M tumours were treated with WLE or SM. There was no recurrence in B and BL group when the margin was ≥1 cm. All non-metastatic M tumours received adjuvant RT irrespective of their margin status. Total 3/16 patients with M developed local recurrence. Total 6/16 M patients had distant metastases (lung or bone). Our median duration of follow up was 20 months (range: 1-120 months).
  
  
  CONCLUSIONS
  Surgical resection with adequate margins (>1 cm) gave excellent local control in B and BL tumours. For patients with BL PT, local radiotherapy is useful, if margins are close or positive even after the best surgical resection. There is a trend towards improved local control with adjuvant radiotherapy for malignant PT. Metastatic malignant PT has a poor outcome.
authors.affiliation: Associate Physician, Department of Radiation Oncology, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Sunitha Susan
authors.initials: SS
authors.lastname: Varghese
authors.affiliation: Associate Professor, Department of Radiation Oncology, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Balukrishna
authors.initials: B
authors.lastname: Sasidharan
authors.affiliation: Professor, Department of Pathology, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Marie Therese
authors.initials: MT
authors.lastname: Manipadam
authors.affiliation: Professor, Department of Surgery, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: M J
authors.initials: MJ
authors.lastname: Paul
authors.affiliation: Professor, Department of Radiation Oncology, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Selvamani
authors.initials: S
authors.lastname: Backianathan
keywords: Borderline phyllodes tumour; Malignant phyllodes tumour; Postoperative radiotherapy; Simple mastectomy; Wide local excision