Phyllodes tumour of the breast: a retrospective analysis of 30 cases

Phyllodes tumour (PT) is a rare neoplasm of the female breast that resemble s fibroadenoma but occurs in an older age group. We retrospectively reviewe d the medical records of 30 women who were treated for phyllodes tumour in our centre. Histological examination was performed by an experienced breast pathologist in all cases and tumours were classified as benign, border lin e malignant or malignant, according to standard hisotological criteria. The mean age at diagnosis was 49) years (range: 19-80 years). Twenty-one (7 0%) of 30 tumours were benign and 9 (30%) were malignant (n=7) or borderlin e malignant (n=2). The mean tumour size was 46 mm (range : 20-100 mm). The final microscopic margins contained tumour in 13 (43%) of 30 cases and were free of tumour in 17 (57%) of 30 patients. After a median follow-up period of 6 years (range : 6 months - 20 years), t he tumour recurred locally in 5 (17%) patients. One patient had six local r ecurrences over an 18-year period. Local recurrences were more frequently o bserved in patients with malignant tumours compared with those with benign lesions (33% versus 10%). However, this association failed to reach statist ical significance. There was no association between local recurrence, patie nt age, tumour size or positive microscopic margins. There was one death (3 %) associated with a completely excised malignant tumour. The present study suggests that histological type and margins do not accura tely predict the clinical course of PT and that there is a need to identify novel biological markers that more accurately predict the behaviour of thi s rare neoplasm. (C) 1999 Harcourt Publishers Ltd.