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Mammary phyllodes tumour: a 15-year multicentre clinical review
  1. Michael Co1,
  2. Clement Chen1,
  3. Julia Y Tsang2,
  4. Gary Tse2,
  5. Ava Kwong1
  1. 1Department of Surgery, Division of Breast Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
  2. 2Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
  1. Correspondence to Dr Ava Kwong, Division of Breast Surgery, Room K1401, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China; avakwong{at}hku.hk

Abstract

Aims Phyllodes tumour (PT) is an uncommon fibroepithelial tumour of the breast. It has a spectrum of aggressiveness in biological behaviour with chance of local recurrence and, occasionally, metastasis.

Methods A 15-year retrospective review from a multicentre database in Hong Kong was performed.

Results Clinical and pathological records of 465 patients with 469 PTs between 1998 and 2014 were reviewed. Median age of occurrence was 44 years (range 12–86 years). 281 (59.9%) PTs were benign, 124 (26.4%) were borderline and 64 (13.6%) were malignant.

About half of all PTs (239, 51.5%) were between 2 and 5 cm while another 186 (40.1%) were >5 cm in size. Most PT (84.6%) were radiologically benign.

Breast-conserving surgery (BCS) was feasible in 384 (82%) patients, whereas 84 (18%) patients had mastectomy. Multivariate analysis found that positive surgical margin (P<0.001) and BCS (P<0.001) were the only significant risk factors for local recurrence, while large tumour size (P=0.008) and malignant PT histotype (P<0.001) were the only significant risk factors for metastasis.

Long-term prognosis of benign and borderline PT was excellent. After median follow-up interval of 85 months (range 12–180 months), the disease-specific survival of benign, borderline and malignant PT were 99.6%, 100% and 90.6%, respectively.

Conclusions Local recurrence of PTs occurs irrespective of the tumour grade. Surgical margin is the only amendable factor to reduce the chance of recurrence.

  • breast pathology
  • breast
  • surgical pathology

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Footnotes

  • Handling editor Dhirendra Govender

  • Contributors MC is responsible for data collection, analysis and manuscript preparation. AK is responsible for data collection and coordination of database, data analysis and manuscript preparation. CC, GT and JYT all contributed to the study by helping with data collection and analysis.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The University of Hong Kong/Hong Kong Hospital Authority (West Cluster).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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