J Korean Surg Soc.  2008 Mar;74(3):171-176.

Risk Factors of Local Recurrence in Phyllodes Tumor of the Breast according to the Clinicopathological Characteristics

• Park YS
• Kwak BS
• Son BH
• Ahn SH
• Kwak JH

Abstract

PURPOSE: Phyllodes tumor is a rare fibroepithelial disease of the breast that is classified as benign, borderline malignant, or malignant according to the pathological characteristics. To clarify diagnostic criteria for these groups, we analyzed the clinico-pathological characteristics of phyllodes tumors and the risk factors for local recurrence after surgery.
METHODS
Between January 1997 and March 2003, we included 70 cases of recurring, pathologically-confirmed phyllodes tumors after surgery. Medical records were reviewed retrospectively for clinical characteristics and pathologic findings.
RESULTS
The mean follow up period was 69.3 months (range 45.4 to 119.3 months) and mean age, 39.4 years old (range 18 to 63 years old). Benign phyllodes tumors were present in 45 cases (64.3%), borderline malignant tumors in 15 cases (21.4%), and malignant tumors in 10 cases (14.3%). A local recurrence developed in 9 cases (12.9%), with three of these cases benign (33.3%), 5 cases were borderline malignant (55.6%), and 1 case was malignant (11.1%). Borderline malignant cases showed a higher local recurrent rate (6.7%, 33.3%, and 10.0%, P=0.027). The local recurrence rate between the tumor-positive or close (<1 mm) resection margins and non-involved cases was different for benign (7.7% vs. 6.3%, P=0.031) and borderline malignant cases (60.0% vs. 20.0%, ns).
CONCLUSION
Pathologic classification and small resection margins are risk factors for local recurrence in phyllodes tumors. Therefore, borderline malignant phyllodes tumors require wide excision with a sufficient resection margin or a mastectomy to prevent local recurrence.

Keyword

Phyllodes tumor; Local recurrence; Risk factors

MeSH Terms

Breast
Follow-Up Studies
Mastectomy
Medical Records
Phyllodes Tumor
Recurrence
Retrospective Studies
Risk Factors