Publication:

Incidence of phyllodes tumors of breast at a single centre in Allahabad, Uttar Pradesh, India

Background Phyllodes tumor of breast is the rare fibro-epithelial tumor of breast constituting <1% of breast neoplasms. They are locally aggressive tumor and suddenly attain a big size. Fine needle aspiration cytology should have both stromal and epithelial component to make the diagnosis. Wide local excision of 1 to 2 cm margin of normal breast is the treatment of choice for tumour of <10 cm in size and simple mastectomy for tumor more than 10 cm. This study was conducted to evaluate the incidence and outcome after surgery for phyllodes tumor at our centre.

Methods Data of 15 patients at our centre was retrieved retrospectively from January 2011 to April 2016.

Results Out of these 15, 14 were female and 1 was male. 14 of them undergo wide local excision under general anesthesia while in one of the patients simple mastectomy was done. Based on tumor histology they are divided into 3 histotypes i. e. benign, borderline, and malignant. 12 patients were found to be benign, 3 borderline and none malignant. Out of 3 borderline disease patients 1 developed recurrence 8 months later to initial surgery. Wide local excision was done for total of 10 times and every time histopathology revealed borderline phyllodes but last report revealed sarcomatous changes. Patient also developed lung metastases and so was referred to oncology department and review histopathology revealed low grade spindle cell sarcoma. Full radiotherapy and complete course of MAID chemotherapy regimen was given but patient still developed local recurrence and metastasis to lungs. All patients in benign category were doing well and none of them developed recurrences in due course.

Conclusions Phyllodes tumor is an interesting entity for both surgeons as well as pathologists because of its rare occurrence and varied histological features. Rapidly growing nature of this tumor does not necessarily indicate malignant disease. No correlation was found between tumor size and recurrence.