Imaging evaluation of phylodes tumor at the National Institute of Cancerology: 86 patient series

Background

Phyllodes tumor is a rare female breast neoplasm, it resembles fibroadenoma but frequently occurs in older women. The purpose of the current study was to determine which imaging features suggest either benignity or malignancy.

Materials and methods

The clinical and imaging history of 86 women treated for Phyllodes tumor (histologically proven) at our institution was retrospectively reviewed and analyzed.

Results

The mean age at diagnosis was 42.2 years (17–86 years). 59 (67.8%) were classified as low grade, 11 (12.6%) intermediate and 16 (18.4%) high grade. The tumor size range was 1 – 25 cm. Imaging features more characteristic were: high breast density (92.8% high grade, 90% intermediate, and 77.2% low grade); breast distortion (26.6% high grade, 24.4% low grade, and 10% intermediate); circumscribed borders (70% intermediate, 53.3% high grade, and 48.8% low grade); indistinct borders (57.7% low grade, 57.2% high grade, and 50% intermediate), 3 low grade Phyllodes had spiculated borders. With US examination, an hypoechoic mass was the main feature (61.1% low grade, 55.5% high grade, and 20% intermediate); other features were heterogeneous echographic pattern (80% intermediate, 44.5% high grade, and 28.8% low grade); necrosis within the tumor (27.2% intermediate grade, 25% high grade, and 10.1% low grade); architectural breast distortion (13.5% low grade, 11.1% high grade); circumscribed borders (62.1% and 33.3% high grade). All patients had follow-up after 1 – 2 years. In the 1 year follow-up, 2.3% of the patients had locally recurrent tumor (n = 2; 1 intermediate; 1 high grade). At the 2-year follow-up, 4.6% of the patients had recurrence (n = 4; 2 low grade; 1 intermediate grade; 1 high grade).

Conclusion

Necrosis within the tumor was the main feature of malignant Phyllodes tumor (p 0.059), however pathologic correlation is mandatory.