Abstract
Phylloides tumours are rare fibroepithelial breast tumours accounting for 1 % of breast cancers. No UK guidance exists on the assessment, treatment and follow-up of these patients. To assess the diagnostic accuracy of the clinical core biopsy compared to the gold standard excision biopsy and determine the current follow-up practice and recurrence rate of phylloides tumours across two UK hospital trusts. Multicentre retrospective analysis of all cases of phylloides tumours over 6 years at Worcestershire Acute NHS Trust (WANHST) and Gloucestershire Hospitals NHS Trust (GHNHST). 94 Patients included. Mean age 48 years. Mean clinical and radiological size of lesions 31.7 and 35.4 mm, respectively, preoperative core biopsy sensitivity was 87 % for WANHST and 74 % for GHNHST with a positive predictive value of 90 and 100 %, respectively. 29 Different follow-up regimes were observed from the practice of the 10 surgeons observed following diagnosis and resection of tumours. The follow-up length ranged from discharge following one post-operative clinic attendance to 5-year clinical and/or radiological follow-up. 4 Benign and 2 malignant recurrent phylloides tumours were seen. All benign recurrences were local and found independently of follow-up. The earliest benign phylloides recurrence was at 6 years and the latest at 10 years. There is no standard follow-up of benign or malignant phylloides tumours. This study suggests that in the benign group, the risk of recurrence is small. We advocate no routine follow-up of benign phylloides tumours.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sheen Chen SM et al (1991) Cystosarcoma phylloides of the breast: a review of clinical, pathological and therapeutic option in 18 cases. Int Surg 76(2):101–104
Contarini O et al (1982) Cystosarcoma phylloides of the breast: a new therapeutic proposal. Am Surg 48(4):157–166
Reinfuss M et al (1996) The treatment and prognosis of patients with phylloides tumor of the breast: an analysis of 170 cases. Cancer 77(5):910–916
Parker SJ et al (2001) Phylloides tumours: review. Postgrad Med J 77:428–435
Page JE et al (1991) The radiological features of phylloides tumour of the breast with clinicopathological correlation. Clin Radiol 44(1):8–12
NICE Early & Locally advanced breast cancer guidance (2014). http://publications.nice.org.uk/early-and-locally-advanced-breast-cancer-cg80 (last accessed 1st June 2014)
NICE Advanced breast cancer guidance (2014). http://publications.nice.org.uk/advanced-breast-cancer-cg81 (last accessed 1st June 2014)
Association of Breast Surgery Best Practice Diagnostic Guidelines (2014). http://www.associationofbreastsurgery.org.uk/media/4585/best_practice_diagnostic_guidelines_for_patients_presenting_with_breast_symptoms.pdf (last accessed 1st June 2014)
Dillon MF et al (2005) The accuracy of ultrasound, stereotactic and clinical core biopsies in the diagnosis of breast cancer, with an analysis of false negative cases. Ann Surg 242(5):701–707
Komenala IK et al (2003) Core needle biopsy as a diagnostic tool to differentiate phylloides tumor from fibroadenoma. JAMA Surgery 138(9):987–990
Yilmaz E et al (2002) Differentiation of phylloides tumors versus fibroadenomas. Acta Radiologica 43(1):34–39
Pezner RD et al (2008) Malignant phylloides tumor of the breast: local control rates with surgery alone. Int J Radiat Oncol Biol Phys 71:710–713
Strebbing JF et al (1995) Diagnosis and management of phylloides tumour of the breast: experience of 33 cases at a specialist centre. Ann R Coll Surg Eng 77:181–184
Mangi AA et al (1999) Surgical management of phylloides tumors. Arch Surg 134(5):487–492
de Roos WK et al (1999) Factors leading to local recurrence or death after surgical resection of phylloides tumours of the breast. Br J Surg 86:396–399
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Appendix 1
Appendix 1
Data Collection Sheet
PID
Age
Clinical assessment of lump
Radiological assessment of lump
Radiological size of lump
Core biopsy result
Excision biopsy result
Excision margin achieved
Follow-up undertaken
Tumour recurrence
Treatment of tumour recurrence
Rights and permissions
About this article
Cite this article
Mylvaganam, S., Toro, C., Frank, L. et al. Phylloides tumours of the breast: best practice for follow-up. Updates Surg 67, 91–95 (2015). https://doi.org/10.1007/s13304-015-0278-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13304-015-0278-3