Surgical methods for the treatment of breast phylodes tumors - a report of 319 cases

Abstract

Breast phyllodes tumors (FT) belong the fibroapitelial group of breast tumors arising in terminal ductulo-lobular unit (TDLU). Their incidence do not exceed 1% of all breast tumors. Biologicaly they can be divided into benign, borderline and malignant group. Incomplete tumor excision can be the reason for local reccurence. Malignant form of FT metastazise hematogenous most often in the lung. There is no uniform surgical opinion about the treatment FT. Methods: We analyzed histopathology features of 319 FT of the breast surgically removed on Department of surgery Institut of oncology and radiology of Serbia between 1.1.1985.- 31.12.1994 . Retrospective study of surgical treatment 84 patients with FT of the breast (69 benign ,4 borderline and 11 malignant ) and 5 year follow up after surgery we analyzed. Results: local recurrence after surgery was found in 17 (20,2 %) patients(14 benign , 2 borderline and 1 malignant FT ), pulmonary metastases in 6 (7,1%) patients with malignant FT. DFI was 21,3 months for local recurrences and 25,1 months for pulmonary metastases . DFS for al forms of FT was 71 % ( p =0,7104 ) in 5- year follow up . Conclusion: According to biological behavior we propose wide excision for benign and borderline forms and simple mastectomy for malignant FT, and voluminous benign and borderline forms. Axillary disection is not necessary because lymphatic spread of malignant FT is unfrequent.