En-bloc excision of phyllodes tumour of the breast: Radical approach heralds’ better outcome

Abstract Introduction Surgery is the primary treatment of phyllodes tumour of breast and margins are most important risk factor associated with local recurrence. We conducted a retrospective audit of 433 patients treated at our centre. Method Women who presented between 1999 to 2017, with phyllodes were included in the analysis. Data was collected from the hospital medical records, telephonic interview and electronic mail. Results Of the 433 women included in this study 177 (40.9%) had benign phyllodes, 84 (19.4%) were borderline, 131 (30.3%) were malignant and 41(9.5%) sarcoma. History of previous excision was noted in 154 (35.6%) of which 104 presented with local recurrence. Of these 209(48.3%) underwent breast conservation surgery, median pT was 6 cm. At a median follow up of 37.9 months, the 5 year disease free survival (DFS) was 82.9%. On a Multivariate analysis, factors histology (HR 4.1, 95% CI 1.5 -10.9, p = 0.005 ) and history of previous excision biopsy (HR 3.39, 95% CI 1.76-6.52, p Conclusion Previous history of excision and histological subtype of phyllodes tumour are factors that have an impact on DFS. Thus emphasizing the need for appropriate surgical planning and en bloc excision of the phyllodes at presentation.