Phyllodes Tumour of the Breast: A Retrospective Analysis from a Tertiary Care Cancer Centre of India

Phyllodes tumours(PT) are rare breast neoplasms with surgical excision as the standard treatment. Recurrence rates are high in malignant PT with high mortality and limited options for adjuvant systemic therapy. We aimed to study the clinicopathological factors and survival outcomes of PTs. Our institution's retrospective review of 172 PT patients from 2011 to 2020. Data were collected from hospital electronic medical records and prospectively maintained REDCAP database. Data analysis was performed using software SPSS 25 & STATA 14 SE. Of the 172 patients, 51(29.6%) had benign, 56(32.5%) had borderline, and 65(37.9%) had malignant PT. The negative margin (no ink on tumour margin for benign and 1 cm microscopic margin for borderline and malignant PT) was ensured in all patients. 87 patients have received adjuvant radiotherapy {28/56(50%) in borderline and 59/65(91%) in malignant PT}. The local recurrence rate was 4% in benign and borderline PT. The recurrence rate in Malignant PTs was 21.5%: 4.6% local recurrence and 16.9% distant metastasis, the lung being the most common site of metastasis, followed by bone. The 8-year estimated DFS and OS were 72% in malignant PT patients. All the events occurred in the first two years of treatment. The average life span after distant metastasis detection was four months only (1,11 months). Our cohort's low local recurrence rate of 4% indicates the importance of considering adjuvant radiation in carefully selected borderline and malignant PT patients. Systemic metastasis is common in malignant PT with a bad prognosis due to ineffective systemic treatment.