Factors Effective on Recurrence and Metastasis in Phyllodes Tumors

Abstract

Background and Aim: Phyllodes tumors (PT) are rare biphasic breast tumors containing stromal mesenchyme and epithelial components. It was classified as benign, borderline, and malignant by the World Health Organization (WHO). Although there is no certainty about the size of the desired margin in the surgery to be applied, a tumor-free area of 1 cm is often targeted. Our study aimed to determine the subtype rates in patients with PT and evaluate the surgical margin, recurrence, and survival times obtained after the surgery. Patients and Methods: This study was conducted at Seyhan Goverment Hospital and involved the PT patients treated between January 2010 and June 2020. We analyzed PT patients retrospectively. Sixty-one patients with PT were analyzed. In the patient, demographic characteristics, body mass index (BMI), surgical procedures, tumor type, size, mitosis rate, and distance of tumor to surgical margin were evaluated. During follow-up, reoperation, recurrence, metastasis, survival times, and mortality rates were evaluated. Results: Sixty-one phyllodes breast tumor patients whose histopathology was reported as malignant, borderline, and benign were evaluated and presented in our study. The mean age was 37.84 (15–100), and the BMI was 25.78 (±5.35) mm. Of the 61 patients, 41 (67.2%) were diagnosed with benign phyllodes tumor (BPT), 10 (16.4%) as borderline phyllodes tumor (BLPT), and 10 (16.4%) as malignant phyllodes tumor (MPT). Conclusions: Preoperative diagnosis of PT can reduce the rate of secondary surgical procedures and the loss of extra breast tissue. A large diameter needle and sufficient number of tissue samples for preoperative core biopsy may increase the rate of accurate diagnosis.

Karakteristik Klinikopatologik Tumor Phyllodes Di Rsup Prof. Dr. I G.N.G. Ngoerah Periode 2018 – 2021

“…31 Hasil yang bertentangan tersebut juga didapatkan pada penelitian oleh Altiok dan Kurt yang menemukan bahwa sebanyak 37 pasien memiliki TP berlateralisasi kiri dan hanya sebanyak 24 pasien berlateralisasi kanan. 32 Jumlah kejadian TP pada payudara kiri yang lebih tinggi dapat didasari oleh karena jumlah penduduk dunia yang sebagian besar menggunakan tangan kanan sebagai ekstremitas dominan. Hal ini dikaitkan dengan preferensi ibu menyusui ketika sedang memberikan ASI kepada anak.…”

“…Meskipun demikian, Altiok dkk melaporkan hasil yang bertentangan terkait distribusi lateralisasi TP jinak dan borderline. 32 Adapun eksistensi dari variasi hasil penelitian ini dan penelitian-penelitian sebelumnya dapat menjadi suatu indikasi akan adanya ketidakpastian dari hubungan antara lateralisasi dengan grading histopatologi TP. Oleh sebab itu, korelasi yang ada antara lokasi dan tingkat keparahan tumor masih belum dapat disimpulkan pada penelitian ini.…”

Case report: Osteosarcomatous differentiation in the lung metastasis of a malignant phyllodes tumor

“…Some tumors may show heterologous differentiation, including liposarcomatous, fibrosarcomatous, osteosarcomatous, chondrosarcomatous, and rhabdomyosarcomatous structures, indicating a poorer prognosis ( 2–4 ). Distant metastases occur in 23% of MPTs and show histological features similar to the primary tumor ( 5 ). We report a case of pleomorphic liposarcomatous primary MPT with osteosarcomatous lung metastasis.…”