Phyllodes tumors of the breast

The aim of this study was to describe the clinical, mammographic, and sonog raphic findings of phyllodes tumor of the breast and correlate them to the benign or malignant pathological nature of the lesion and its clinical beha vior. We retrospectively reviewed the clinical, radiologic, and pathologic findings of 12 cases of phyllodes rumors diagnosed in our hospital in the p ast 6 years, 6 of which were malignant. The surgical management and clinica l course of the patients were also reviewed. Mammographically, soft tissue masses ranging from 2.5 to 15 cm were present in all patients. One patient had a mixed fat and water density mass and 2 patients had masses associated with coarse calcifications. At sonography, all tumors were well circumscri bed; two of them were homogeneously hypoechoic, and the rest had heterogene ous internal echoes. Eight patients showed internal cystic areas. None of t hese characteristics proved to be useful in ascertaining the benign or mali gnant nature of the tumor. At surgery, 5 patients underwent mastectomy and 7 patients local excision of the tumor. Three of the later tumors, one beni gn and two malignant, recurred after several months. Fine-needle aspiration biopsy suggested the diagnosis of phyllodes tumor in only 3 cases. After s urgery sh tumors were classified as benign and six as malignant, three of w hich being of low-grade malignancy. None of the clinical or radiologic char acteristics of the tumors were useful in predicting their histological natu re or their behavior after surgery. Preoperative fine-needle aspiration bio psy often misdiagnosed the tumor as benign fibroadenoma. Only the histopath ologic features of the excised mass proved to be helpful in assessing malig nancy.