Surgical Resection of Phyllodes Tumour: a Radical Approach as a Safeguard Against Local Recurrence

Badwe, Rajendra; Kataria, Kamal; Srivastava, Anurag

doi:10.1007/s12262-013-0935-z

Cited by 11 publications

(5 citation statements)

References 2 publications

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“…While some advocate a 1 cm margin according to the NCCN guidelines, others advocate a 2 cm margin ; it has also been suggested that the 1 cm margin recommended by the NCCN is overtreatment. 4,8,9 Adequacy of excision is vital, but the removal of excess normal tissue may pose an additional surgical challenge in the reconstruction of the exposed raw area. A multidisciplinary team approach is recommended to ensure the best closure and cosmesis for the patient.…”

Section: Discussionmentioning

confidence: 99%

Phyllodes tumour presenting in a rare location: a case report and literature review

et al. 2022

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Phyllodes tumors are rare fibro-epithelial tumors that are known to grow very rapidly in a short period. The tumor is known for its propensity to recur locally despite adequate wide excisions and even mastectomies. This case report is of a woman who had a recurrent Phyllodes tumor in a peculiar location. Phyllodes tumours are generally confined to arising from the breast; however, in this case, we found it arising from the anterior abdominal wall. The tumour was removed with a 2 cm margin of excision. The large defect that remained after excision was reconstructed using a latissimus dorsi flap, along with a split skin graft. The immediate post-operative period was uneventful. Ultrasonography did not detect a recurrence after 12 months. We presented relevant literature highlighting tumor infiltration into the anterior abdominal wall, our surgical management and reconstructive planning for closure of a large post-excision defect. In order to prevent a recurrence of phyllodes tumour, it is important to excise the tumour with wide margins of 2 cm. A multi-disciplinary team approach is essential for the reconstruction of the remaining defect.

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Section: Discussionmentioning

confidence: 99%

Phyllodes tumour presenting in a rare location: a case report and literature review

et al. 2022

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“…Surgical options include wide local excision or mastectomy with or without reconstruction. Radical excision of large PT mass helps to reduce local recurrences [15]. As axillary metastasis is very rare, combined lymph node dissection is usually avoided.…”

Section: Discussionmentioning

confidence: 99%

Metastatic Malignant Phyllodes Tumor of the Breast: An Aggressive Disease—Analysis of 7 Cases

Ramakant

Selvamani

Therese

et al. 2015

Indian J Surg Oncol

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Malignant phyllodes tumor (PT) of the breast behaves aggressively and the presentation of distant metastases is varied, ranging from synchronous or short interval commonly to a decade rarely. To assess the clinical and temporal pattern of distant metastases in malignant PTs. A retrospective analysis of patients with Phyllodes tumor of the breast from January, 2001 to November, 2014. There were a total of 167 patients with PT; 49 (29 %) were malignant PT out of which 7 developed distant metastases. Detailed analysis of these 7 patients showed that mean age was 36.71 years (range 28-53 years). Three of the seven patients had additional local recurrences post lumpectomy. The procedure performed were wide local excision with muscle reconstruction (n= 1), lumpectomy (n=1) and mastectomy (n=5). The distant metastases were synchronous (n=2) and other 5 had metastases developing within 2 months to 13 years. The sites for distant metastases included lung, brain, adrenal, paraaortic nodes and bone. Six patients received palliative chemotherapy (CT) and 2 also had radiation therapy for brain metastasis. Only 1 patient is alive and receiving CT and all others succumbed to the disease. Patients with malignant PT of the breast with distant metastases behave aggressively and have a dismal outcome with rare exceptions. They need multimodality therapy and close follow up. Newer targeted therapies may have a role to improve the outcome.

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“…The presence of a pseudo capsule containing finger-like or pseudopodia-like projections around the phyllodes tumor tissue is likely, which, if not surgically excised, leads to a local recurrence. Therefore, the tumor with 1-2-cm width of normal tissue should be removed including 11,12 these pseudopodia of tumors. Total mastectomy is in general not suggested due to poor cosmetic outcomes, unless negative margins cannot be conducted or if the tumor is too large to be completely excised.…”

Section: Case Presentationmentioning

confidence: 99%

Large Malignant Phyllodes Tumor of the Breast: Case Report of a Young Female and Review of Literature

2020

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Background: Phyllodes tumors are rare fibroepithelial neoplasm of the breast, representing 0.3 to 0.5% of all female breast neoplasms. The term ‘‘phyllodes tumor” by the World Health Organization (WHO) categorizes it into benign, borderline, and malignant tumors based on histopathological characteristics. Malignant phyllodes tumor is an uncommon but aggressive breast malignancy and accounts for approximately 25% of all phyllodes tumors.Case Presentation: A 23-year-old female patient Gravida 0 Para 0, previously healthy, with no family history of breast or ovarian cancer was referred to our institution for managing a right breast mass increasing in size over a period of 1 month associated with reddish-brown discoloration of the skin. Breast ultrasound showed an isodense oval mass measuring approximately 16x14x12cm in the right lower outer quadrant of her breast. Core biopsy and FNA done revealed a low grade phyllodes tumor. MRI of breasts showed a huge mass of the right breast occupying all quadrants, measuring 15x14.5 cm in its greatest axis with involvement of the pectoralis major muscle, with no evidence of suspicious axillary lymphadenopathy. Distant metastatic work-up with CT scan of chest abdomen and pelvis and a PET scan did not show distant metastasis. Hence, the patient underwent right total mastectomy with a final pathology compatible with malignant phyllodes tumor. She is on regular follow up and 18 months post-surgery is still disease free.Conclusion: Management of malignant phyllodes tumor remains debatable, especially when it comes to the effect of adjuvant radiotherapy and chemotherapy. From a surgical perspective, whether phyllodes tumors should be considered as epithelial breast cancers or as soft tissue sarcoma is another debate. On the other hand, although challenging, accurate identification of phyllodes tumor initially may aid in decreased recurrence.

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Surgical Resection of Phyllodes Tumour: a Radical Approach as a Safeguard Against Local Recurrence

Cited by 11 publications

References 2 publications

Phyllodes tumour presenting in a rare location: a case report and literature review

Phyllodes tumour presenting in a rare location: a case report and literature review

Metastatic Malignant Phyllodes Tumor of the Breast: An Aggressive Disease—Analysis of 7 Cases

Large Malignant Phyllodes Tumor of the Breast: Case Report of a Young Female and Review of Literature

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