Phyllodes tumours of the breast

BACKGROUND: Phyllodes tumour is a very rare fibroepithelial neoplasia of the female breast. As a consequence of its low worldwide incidence of 0.3–1% of female breast tumours, the diagnosis, treatment, and prognosis of this disease are largely speculative and unresolved. A nationwide multicentre analysis was carried out with the objective of describing the diagnostic and therapeutic methods currently used and assessing the prognosis of this rare disease. METHODS: From April 2000 to June 2001 a computer-assisted survey was carried out in 24 surgical and gynaecological departments in Austria. Using a data sheet, the departments collected information on phyllodes tumours treated until present, as well as the follow-up care, treatment, and the long-term results. RESULTS: Across Austria 85 cases of women with phyllodes tumour covering the period from January 1985 to December 2000 were included in this study. In 40 (47%) cases the tumour was localised in the left breast, in 37 (44%) cases it was in the right breast. The histological review of the surgical specimens found that 28 (33%) patients had a malignant phyllodes tumour. Eight (9%) cases were borderline and 46 (54%) benign. The mean follow-up time was 39 (11–85) months. Seven patients died during the study. CONCLUSIONS: Patients with borderline and benign lesions should also undergo regular follow-up. A breast-conserving operation with adequate excision margins should be the primary objective, since even malignant tumours seldomly metastasise.