272 Clinico-Pathological Factors Determining Recurrence in Phyllodes Tumour of the Breast: The 25-Year Experience at a Tertiary Cancer Centre
B Sain, A Gupta- Surgery
Abstract
Aim
The study aimed to assess the clinico-pathological features, diagnostic modalities and therapeutic interventions with their outcomes leading to recurrence in Phyllodes tumour (PT) of breast.
Method
A retrospective observational study entailing clinico-pathological data of patients who were previously diagnosed or presented with new PT of the breast between 1996-2021 was done. Data included- total number of patients diagnosed with PT, age, type of tumour on initial presentation and biopsy, side, size, therapeutic interventions- surgery (mastectomy or lumpectomy) and adjuvant radiotherapy, final biopsy type, recurrence and its type and time to recurrence.
Results
Among the total 87 patients who were pathologically proven to have PT, 52.87%(n = 46) were found to have recurrence. All patients were recorded to be in the female gender with a mean age of diagnosis at 39 years (range 15–70). Age<40 years had the highest incidence of recurrence (54.35%) followed by age>40 years with 45.65%. 55.4% patients presented with primary phyllodes and 44.6% had recurrent phylloides at presentation. Average time of local recurrence from the time of completion of treatment were 13.8 months whereas for systemic recurrence it was 15.29 months. Surgery(mastectomy/lumpectomy) was the major determinant for local recurrence(p<0.05) followed by adjuvant radiotherapy(p = 0.04) and initial biopsy type for systemic recurrence(p<0.05).
Conclusion
Patients who received adjuvant radiotherapy had minimal recurrence. Patients who were found to have malignant tumour on initial biopsy were prone to systemic recurrence over local recurrence. Surgery played a determining factor leading to an increased rate of local recurrence following lumpectomy over mastectomy.