Title: Phyllodes Tumor of Breast: A Case Series with Review Literature In A Rural Hospital
Authors: Dr Brjamohan Mishra, Dr Ashok Ku. Nayak, Dr Rabinarayan Guru, Dr Akshay Behera
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.88
Abstract
Although phyllodes tumor (PT) is an uncommon fibro epithelial tumor of the breast, due to its variation in nomenclature, presentation, and diagnosis, it has posed many problems for the surgeons around the world. Its clinical spectrum ranges from a benign, borderline to malignant with or without metastasis.
Aim: This a prospective study, aims to evaluate clinical characteristics, Histopathological diagnosis, Treatment regimen, Recurrence and survival of the patients with late complications.
Patients & Method: This study is done in V.S.S. Medical College, Burla, a rural hospital in India. Here we have enrolled 36 patients who are clinically, radiologically (USG &Mammography) and by FNAC, diagnosed as PT, under gone various type of surgical procedures and followed for recurrence and other late complications.
Result: The mean age at diagnosis is 38.5 years, 25(69.4%) are benign, 4(9%) are borderline, and 7(19.5%) are malignant,. mean size of the tumor 7.12cm, right side tumors are 21 and left side are 14.patients are followed up for 6 to 36 month period with 7 (19.4%) recurrence, 9 loosed follow up and 2 died due to metastasis.
Conclusion: For correct surgical planning, wider excision and to prevent local recurrence accurate preoperative pathological diagnosis is needed. It should be differentiated from malignant PT and other benign breast lesions and treat them accordingly
Keywords: Phyllodes tumor, Histopathological study , wide local excision.
References
1. M. D. Rowell, R. R. Perry, J. G. Hsiu, and S. C. Barranco, “Phyllodes tumors,” The American Journal of Surgery, vol. 165, no. 3, pp. 376–379, 1993.
2. B. Salvadori, F. Cusumano, R. Del Bo et al., “Surgical treatment of phyllodes tumors of the breast,” Cancer, vol. 63, no. 12, pp. 2532–2536, 1989.
3. L. Bernstein, D. Deapen, and R. K. Ross, “The descriptive epidemiology of malignant cystosarcoma phyllodes tumors of the breast,” Cancer, vol. 71, no. 10, pp. 3020–3024, 1993.
4. Fiks, “Cystosarcomaphyllodes of the mammary gland—Muller's tumor,” Virch-ows Archiv, vol. 392, no. 1, pp. 1–6, 1981.
5. M. Chelius, Neue Jahrbucher Der Teutschen Medicin and Chirurgie, Naegele und Puchelt, Heidelberg, Germany, 1827.
6. World Health Organization, Histologic Typing of Breast Tumors, vol. 2, WHO, Geneva, Switzerland, 2nd edition, 1981.
7. C. L. Chua, A. Thomas, and B. K. Ng, “Cystosarcomaphyllodes: a review of surgical options,” Surgery, vol. 105, no. 2 I, pp. 141–147, 1989.
8. M. A. Mendel, R. G. DePalma, C. Vogt, and J. W. Reagan, “Cystosarcoma-phyllodes: treatment by subcutaneous mastectomy with immediate prosthetic implantation,” The American Journal of Surgery, vol. 23, pp. 718–721, 1972.
9. S. C. Carabell and R. L. Goodman, “Radiation therapy for soft tissue sarcoma,” Seminars in Oncology, vol. 8, no. 2, pp. 201–206, 1981.
10. G. V. Burton, L. L. Hart, G. S. Leight, J. D. Iglehart, K. S. McCarty, and E. B. Cox, “Cystosarcomaphyllodes. Effective therapy with cisplatin and etoposide chemotherapy,” Cancer, vol. 63, no. 11, pp. 2088–2092, 1989.
11. P. F. Ridgway, R. K. Jacklin, P. Ziprin et al., “Perioperative diagnosis of cystosarcoma phyllodes of the breast may be enhanced by MIB-1 index,” Journal of Surgical Research, vol. 122, no. 1, pp. 83–88, 2004.
12. R. K. Jacklin, P. F. Ridgway, P. Ziprin, V. Healy, D. Hadjiminas, and A. Darzi, “Optimising preoperative diagnosis in phyllodestumour of the breast,” Journal of Clinical Pathology, vol. 59, no. 5, pp. 454–459, 2006.