gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

33 Cases of Breast Phyllodes Tumor: A Clinical Review over the Last 20 Years

Meeting Abstract

  • corresponding author presenting/speaker Miriam Susanne Lenhard - Department of Obstetrics and Gynecology, Grosshadern, University of Munich, Germany
  • Steffen Kahlert - Department of Obstetrics and Gynecology, Grosshadern, University of Munich
  • Isabelle Himsl - Department of Obstetrics and Gynecology, Grosshadern, University of Munich
  • Nina Ditsch - Department of Obstetrics and Gynecology, Grosshadern, University of Munich
  • Michael Untch - Department of Obstetrics and Gynecology, Grosshadern, University of Munich
  • Klaus Friese - Department of Obstetrics and Gynecology, Grosshadern, University of Munich
  • Ingo Bauerfeind - Department of Obstetrics and Gynecology, Grosshadern, University of Munich

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocOP006

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Veröffentlicht: 20. März 2006

© 2006 Lenhard et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: The “Cystosarcoma phyllodes” of the breast is a rare entity which accounts for 0.5 % of all breast neoplasms. The diagnosis should be considered in all rapidly growing breast nodules. We reviewed all cases of this rare disease that presented at our hospital in the last 20 years.

Patients and Methods: The data of 5270 patients with primary breast neoplasms treated in our department between 1984 and 2005 were retrospectively analyzed for the histopathologic diagnosis of a cystosarcoma phyllodes.

Results: 33 patients with cystosarcoma phyllodes of the breast could be identified. The median age at diagnosis was 47 years. Median follow up was 86 months. The tumors were classified histologically into benign (40%), borderline (27%) and malignant tumors (33%) based on standardized criteria; 3 tumors were unclassified. Surgery was conducted as a breast conserving (58%) or radical surgery (mastectomy) (42%). Only one patient was treated with adjuvant radiotherapy after primary surgery. Median tumor size was 7.1 cm, and no lymph node infiltration was found in the 8 patients who received axillary lymph node dissection. Local recurrence occured in 8 patients (26%). 75% (6/8) of these patients had been treated with breast conserving surgery. In patients with the diagnosis of a malignant phyllodes tumor we observed a recurrence rate of 40% (4/10), in those with borderline tumors of 25% (2/8) whereas those with benign phylloides tumor had a local relapse rate of 8% (1/12). Distant metastases were seen in 4 patients (12%) with a malignant phyllodes tumor. All patients with distant metastases in the follow up had been treated radically (mastectomy) at primary diagnosis. Neither regarding age at primary diagnosis nor tumor size there was a significant difference between patients with local recurrence or metastatic spread and those without (p=0.284 tumor size, p=0.739 for age, Wilcoxon-W).

Conclusion: We recommend local excision with appropriate surgical margins in all patients if the tumor-to-breast ratio is sufficient for good cosmesis. Routine axillary dissection should not be recommended. This recommendation is concordant with other studies since lymph node involvement is a rare event. Patients with a malignant tumor are at higher risk for local recurrence and metastatic spread. The histopathologic classification seems to be the strongest prognostic factor in this disease.