Value of Adjuvant Radiotherapy in Borderline and Malignant Phyllodes Tumors: Mansoura University Experience

Abstract

Introduction: Phyllodes tumors are rare type of breast cancer. Surgery still the first option of treatment; post-operative treatment is a matter of debate specially when considering radiotherapy. Many risk factors could affect the incidence of local recurrence. Aim: Study the impact of adjuvant radiotherapy on recurrence rate, local recurrence free survival and overall survival for cases of borderline and malignant phyllodes tumors and to study the risk factors associated with high incidence of local failure. Methods: A retrospective cohort analysis done on cases of breast border line or malignant phyllodes tumors. Patients were divided into two groups; group A (90 cases) received adjuvant radiotherapy; group B (86 cases) underwent surveillance after surgery. Period of follow up ranged between 24 and 164 months (median 94 months).  Results: 7 cases (7.8%) in group A developed local recurrence compared to 18 cases (20.9%) in group B with significant P value. comparing failed cases, LRFS was 42.00± 4.32 months in group A compared to 29.16± 5.89 months in group B. P value (≤0.001*). OS was 102.82± 42.53 months in group A compared to 93.01± 43.07 months in group B. P value was insignificant. The cumulative survival after 50 months is 92% when the tumor is less than 8 cm compared to 78 % when the tumor is more than 8 and was 98% when the tumor is borderline compared to 74 % when the tumor is malignant. Conclusion: Adjuvant radiotherapy for borderline and malignant phyllodes tumors decreases recurrence rate and improves DFS.