Clinical Outcome of Patients with Breast Phyllodes Tumors: A Retrospective Analysis of 129 Cases in Shiraz, Southern Iran

Phyllodes tumors are uncommon neoplasms of the breast. Data about their outcome is limited. This study aims to evaluate patients diagnosed with phyllodes tumors in terms of local recurrence, distant metastasis and overall survival. We retrospectively reviewed the medical records of 129 women with phyllodes tumors who referred to our center from 1999 to 2013. Clinical and pathological features, local and regional recurrence, distant metastasis and overall survival were determined. SPSS 15.0 statistical software was used for analysis.Mean patient age was 39 years (17-67 years). Mean size of the tumor was 5.38 cm. There were 105 (81.4%) benign, 8 (6.2%) borderline and 16 (12.4%) malignant tumors. The mean follow-up period of patients was 28 months (6 to 128 months). The rate of local recurrence among benign tumors was 3.8% (4 cases); in borderline cases the rate was 12.5% (1 case) and for malignant cases, it was 18.7% (3 cases). Three patients each recurred twice and one patient had local recurrence for a third time. Two patients died of malignant tumor-related disease - one due to advanced regional recurrence and lung metastasis, and the other to wide-spread metastasis. Another patient died from an unrelated cause (myocardial infarction) one year after surgery. For those with malignant phyllodes tumors, the five-year overall survival was 77.8% and disease-free survival rate was 85.7%. Although, the prognosis for phyllodes tumors is good, the malignancy rate is higher in older patients and those with larger tumors. A higher local recurrence rate in malignant phyllodes tumors suggests the importance for adequate resection of margins in surgical management of these tumors.