Phyllodes tumor of the breast

Background. Phyllodes tumor is a rare breast neoplasm, generally benign and still not perfectly classified. Methods. 22 patients with phyllodes tumor (benign 16, borderline 3, malignant 3) were observed. In the first group, 15 were submitted to wide resection and 1 to subcutaneous mastectomy; in the second group 2 to wide resection and 1 to subcutaneous mastectomy; in the third group 1 to wide resection, 2 to mastectomy. Results. In the first group, a patient died at 111 months for not neoplastic causes, one had a local relapse after 25 months treated by wide resection, the others are free from relapse at 5-158 months. In the second group, 2 patients treated by wide resection had a local relapse after 12 and 48 months and were submitted to mastectomy and new resection respectively. The last one presented a new relapse after 48 months treated by mastectomy. Both are free from disease at 224 and 130 months. The third patient is free from relapse at 45 months. In the third group the patient with diagnosis of benignity had a local relapse after 8 months and died at 24 months of widespread metastases; the others developed lung metastases after 12 and 41 months treated by chemotherapy and lobectomy respectively. The first is alive with disease at 31 months, the second free of disease at 50 months. Conclusions. In conclusion, phyllodes tumor is a poorly known neoplasm in which the histopathologic features are not strictly correlated with the biological behavior; conservative surgery finds indication when, as well as a good local control, offers a good aesthetical result.