Study of clinicopathological factors and their impact on survival in phyllodes tumour of breast at tertiary care cancer centre in India

Abstract

Background: Phyllodes tumour is a rare breast neoplasm having three histological types i. e benign, borderline and malignant. Surgical excision is the mainstay of treatment, but quantification of adequate margin required during excision is still a matter of debate. Role of adjuvant radiotherapy also remains controversial. Aims: Study of prognostic factors in patients with phyllodes tumour of breast and their effect on survival. Setting and design: A retrospective analysis. Material and methods: From the year 2016 to 2019 we included 54 patients in this study and assessment of clinical and histopathological features, requirement of adjuvant radiotherapy and their effect on DFS (disease free survival) and OS (overall survival) was done. Log-rank test was used for univariate analysis and multivariate analysis was done by using Cox propotion hazard ratio method. Statistical analysis: Descriptive statistics was used for calculating proportion and median value. Survival analysis was done by using Kaplan Meier method. P value of <0.05 was considered statistically significant. Results: Mitotic count and presence of heterologous component had significant effect on overall survival (OS) and disease free survival (DFS) on multivariate analysis. No effect of adjuvant radiotherapy and the type of surgery (breast conservation surgery v/s mastectomy) was found on survival (OS, DFS). Conclusion: Surgery with adequate margins should be the treatment of choice for tumours with borderline and malignant histological type Histological features like high mitotic count and stromal overgrowth are known prognostic factors, however, heterologous component is also an important prognostic factor and should be studied in large randomized trials. Role of adjuvant radiotherapy remains controversial.

Keywords

• Phyllodes tumour
• Benign
• Borderline
• Malignant
• DFS
• OS