Liu H, Lai ES, Lu SQ, G oh MH, Chen JJC, Chan PMY and Tan EY*
Department of General Surgery, Tan Tock Seng Hospital, SingaporeFulltext PDF
Background: Malignant phyllodes tumours are rare cancers of the breast. Surgery is the primary mode of treatment and current adjuvant treatments appear ineffective. Survival is extremely poor when distant metastasis develops.Aims: We retrospectively reviewed 30 women who underwent surgery for malignant phyllodes tumours at our unit over a 16-year period. Clinical outcome, particularly the development of distant metastasis, was examined and factors associated with distant metastasis were evaluated.Results: Median age was 55 years. All but 2 women presented with a palpable breast mass, which was larger than 10 cm in 8. In total, 21 women underwent mastectomy and 9 a wide local excision. Margins remained involved in 4 women even after a mastectomy and 3 received post-operative radiation. Distant metastasis was found in 1 woman on staging scans done in the immediate postoperative period and in another 6 women a median of 5.3 months after surgery. None received chemotherapy and median survival after the development of distant metastasis was 2.2 months. Surgical margin involvement was the only factor associated with distant metastasis (P=0.031, OR 16.499, 95% CI 0.005 to 0.740), but was not significant after adjusting for tumour size (P=0.135, OR 8.348, 95% CI 0.518 to 134.650). Overall survival was 25.5 months and was strongly associated with distant metastasis (P<0.001, HR495.1, 95% CI 55.84 to 4390).Conclusion: Distant metastasis was found in 23% of women with malignant phyllodes tumours and carried a poor prognosis.
Malignant phyllodes tumours; Distant metastasis; Surgery
Liu H, Lai ES, Lu SQ, G oh MH, Chen JJC, Chan PMY, et al. Management of Malignant Phyllodes Tumours of the Breast. Clin Surg. 2017; 2: 1789.