Phyllodes tumors of the breast: A comprehensive review of diagnosis, treatment, and follow-up
Aline Rocha Donato, Rodrigo Gonçalves, Jonathan Yugo Maesaka, Fernando Nalesso Aguiar, José Maria Soares, Carlos Alberto Ruiz, José Roberto Filassi, Edmund Chada Baracat
Abstract
• Molecular and IHC markers aid in objective classification and outcome prediction of PT. • Surgery is the gold standard for PT, but margin extent lacks consensus. • Local recurrence is key in PT prognosis, with margin status as the main risk factor. • Adjuvant radiotherapy lowers recurrence in borderline/malignant PTs with close margins. Phyllodes Tumor (PT) of the breast is a rare type of fibroepithelial neoplasm, classified into benign, borderline, and malignant subtypes. These tumors are known to be locally aggressive and have an inherent potential for Local Recurrence (LR), even after adequate surgical treatment. Establishing strategies to reduce LR has become increasingly important, as 21 % to 36 % of patients experience disease recurrence despite achieving negative surgical margins. Although surgical resection of the lesion is the gold standard treatment for all subtypes of phyllodes tumors, the ideal extent of the surgical margin remains a topic of debate with no consensus in the literature. Adjuvant radiotherapy is suggested as a tool to improve local control of the disease and reduce the recurrence rate; however, published data on this approach are currently conflicting. In this review paper, the authors will provide a detailed analysis of the current evidence on the diagnosis, treatment, follow-up, outcomes, and future perspectives of phyllodes tumors.