J Breast Cancer.  2007 Dec;10(4):248-253. 10.4048/jbc.2007.10.4.248.

Risk Factors for Recurrence After Surgical Treatment of a Malignant Phyllodes Tumor of the Breast

• Lee HS
• Kim HA
• Shin DS
• Kim YH
• Chung SY
• Jin MS
• Kim MS
• Lee JI
• Paik NS
• Moon NM
• Noh WC

• KMID: 2286592
• DOI: http://doi.org/10.4048/jbc.2007.10.4.248

Abstract

PURPOSE: Malignant phyllodes tumors are rare breast tumors. Information on the prognosis and optimal treatment of these lesions is not yet sufficient. The aim of this study was to determine parameters that predict the recurrence of malignant phyllodes tumors of the breast.
METHODS
Retrospectively, we reviewed the medical records and pathological slides of 23 patients with malignant phyllodes tumors that had undergone surgical treatment from 1988 to 2006. The age of the patients, tumor size, type of surgery, resection margin, adjuvant therapy and pathological characteristics of the tumors such as stromal hypercellularity, cellular phleomorphism, mitosis, margins, and stromal pattern were examined.
RESULTS
The mean age of the patients was 41 yr. The tumor size ranged from 1 cm to 25 cm, with a median of 7.42 cm. The median follow-up time was 29.0 months. Recurrence was observed in 6 patients (26.1%) and the 5-yr disease free survival was 48.9%. Risk factors for recurrence of a malignant phyllodes tumor were a mitotic index greater than 10 per high-powered field (p=0.0242) and an invasive margin (p=0.0437).
CONCLUSION
Frequent mitosis and an invasive margin were the principal determinants of recurrence. Patients with poor prognostic components should be treated more aggressively and the patients need more close follow-up.

Keyword

Malignant phyllodes tumor; Breast; Recurrence; Risk factors

MeSH Terms

Breast Neoplasms
Breast*
Disease-Free Survival
Follow-Up Studies
Humans
Medical Records
Mitosis
Mitotic Index
Phyllodes Tumor*
Prognosis
Recurrence*
Retrospective Studies
Risk Factors*

Figure

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  Fig 1 Disease free survival of malignant phyllodes tumor.

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  Fig 2 Disease free survival of malignant phyllodes tumor according to histological feature of margin.

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  Fig 3 Disease free survival of malignant phyllodes tumor according to mitotic index.

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  Fig 4 The number of annual diagnosis of phyllodes tumor.

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