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

Hee-Sang Lee; Hyun-Ah Kim; Dong-Sun Shin; Yang-Hee Kim; Soo-Young Chung; Min-Sun Jin; Min-Suk Kim; Jong-Inn Lee; Nam-Sun Paik; Nan-Mo Moon; Woo-Chul Noh

doi:10.4048/jbc.2007.10.4.248

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Lee, Kim, Shin, Kim, Chung, Jin, Kim, Lee, Paik, Moon, and Noh: Risk Factors for Recurrence After Surgical Treatment of a Malignant Phyllodes Tumor of the Breast

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2007; 10(4): 248-253.

Published online: 30 December 2007

DOI: https://doi.org/10.4048/jbc.2007.10.4.248

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

Hee-Sang Lee, Hyun-Ah Kim, Dong-Sun Shin, Yang-Hee Kim², Soo-Young Chung¹, Min-Sun Jin¹, Min-Suk Kim¹, Jong-Inn Lee, Nam-Sun Paik, Nan-Mo Moon, Woo-Chul Noh

Department of Surgery, Korea Institution of Radiological and Medical Science, Korea Cancer Center Hospital, Seoul, Korea.

¹Department of Anatomical Pathology, Korea Institution of Radiological and Medical Science, Korea Cancer Center Hospital, Seoul, Korea.

²Department of Surgery, Kangwon National University, College of Medicine, Chuncheon, Korea.

nohwoo@kcch.re.kr

Received 12 July 2007 Accepted 27 September 2007

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.

Keywords: Malignant phyllodes tumor, Breast, Recurrence, Risk factors

Figures and Tables

Fig 1

Disease free survival of malignant phyllodes tumor.

Fig 2

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

Fig 3

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

Fig 4

The number of annual diagnosis of phyllodes tumor.

Table 1

WHO criteria for phyllodes tumor(16)

HPF=High powered field.

Table 2

Clinical characteristics for local recurrence factors

Table 3

The relation between tumor-related characteristics and the occurance of local recurrence

NS=not significant; HPF=High powered field.

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