The objective of this study was to examine the clinical characteristics and management of five patients with phyllodes sarcoma of the breast. These patients were followed at the senology unit of the Philippe Maguilen Senghor health center in Dakar between 2012 and 2022. We conducted a retrospective study of five cases of phyllodes sarcoma managed at our unit. We collected clinical, histopathological, and therapeutic data from the patients’ medical records. We also followed the patients’ outcomes, including recurrence and survival, for up to 36 months after treatment. The mean age of the five patients at diagnosis was 28.8 years. Mastectomy was the primary treatment most of the patients. Two patients developed local recurrences within a very short time, between 4 and 20 months. The overall survival rate for the five patients was 40% at 24 months. Phyllodes sarcomas of the breast are rare tumors that require special attention due to their potential for progression. Early diagnosis and adequate surgical resection are crucial to reduce the risk of recurrence. This case report highlights the challenges of managing these tumors and emphasizes the importance of rigorous follow-up.
References
[1]
Haberer, S., Laé, M., Seegers, V., Pierga, J.Y., Salmon, R., Kirova, Y.M., et al. (2009) Prise en charge des tumeurs phyllodes malignes du sein: L’expérience de l’institut Curie. Cancer/Radiothérapie, 13, 305-312. https://doi.org/10.1016/j.canrad.2009.05.001
[2]
El Amine Elhadj, O., Nasri, M., Thabet, S., Ben Hassouna, J., Goucha, A., Rahal, K., et al. (2017) Sarcomes mammaires primitifs: à propos de 30 cas traités à l’institut Salah-Azaiez de Tunis. Cancer/Radiothérapie, 21, 45-50. https://doi.org/10.1016/j.canrad.2016.09.011
[3]
Organisation Mondiale de la Santé (1981) Les types histologiques des tumeurs du sein. In: Classification histologique internationale des tumeurs, Deuxième édition, World Health Organization, 71.
[4]
Tremblay-LeMay, R., Hogue, J., Provencher, L., Poirier, B., Poirier, é., Laberge, S., et al. (2017) How Wide Should Margins Be for Phyllodes Tumors of the Breast? The Breast Journal, 23, 315-322. https://doi.org/10.1111/tbj.12727
[5]
Thind, A., Patel, B., Thind, K., Isherwood, J., Phillips, B., Dhaliwal, K., et al. (2020) Surgical Margins for Borderline and Malignant Phyllodes Tumours. The Annals of the Royal College of Surgeons of England, 102, 165-173. https://doi.org/10.1308/rcsann.2019.0140
[6]
Norris, H.J. and Taylor, H.B. (1967) Relationship of Histologic Features to Behavior of Cystosarcoma Phyllodes.analysis of Ninety-Four Cases. Cancer, 20, 2090-2099. https://doi.org/10.1002/1097-0142(196712)20:12<2090::aid-cncr2820201206>3.0.co;2-l
[7]
Yoshida, M., Ogawa, R., Yoshida, H., Maeshima, A., Kanai, Y., Kinoshita, T., et al. (2015) TERT Promoter Mutations Are Frequent and Show Association with MED12 Mutations in Phyllodes Tumors of the Breast. British Journal of Cancer, 113, 1244-1248. https://doi.org/10.1038/bjc.2015.326
[8]
Piscuoglio, S., Ng, C.K., Murray, M., Burke, K.A., Edelweiss, M., Geyer, F.C., et al. (2016) Massively Parallel Sequencing of Phyllodes Tumours of the Breast Reveals Actionable Mutations, and TERT Promoter Hotspot Mutations and TERT Gene Amplification as Likely Drivers of Progression. The Journal of Pathology, 238, 508-518. https://doi.org/10.1002/path.4672
[9]
Grenier, J., Delbaldo, C., Zelek, L. and Piedbois, P. (2010) Tumeurs phyllodes et sarcomes du sein: Mise au point. Bulletin du Cancer, 97, 1197-1207. https://doi.org/10.1684/bdc.2010.1174
[10]
Damak, T. (2014) Prognostic Factors of Phyllodes Tumors of the Breast: Analysis of 170 Cases. British Journal of Medicine and Medical Research, 4, 2694-2704. https://doi.org/10.9734/bjmmr/2014/4979
[11]
Fou, A., Schnabel, F.R., Hamele-Bena, D., Wei, X., Cheng, B., El Tamer, M., et al. (2006) Long-Term Outcomes of Malignant Phyllodes Tumors Patients: An Institutional Experience. The American Journal of Surgery, 192, 492-495. https://doi.org/10.1016/j.amjsurg.2006.06.017
[12]
Toussaint, A., Piaget-Rossel, R., Stormacq, C., Mathevet, P., Lepigeon, K. and Taffé, P. (2021) Width of Margins in Phyllodes Tumors of the Breast: The Controversy Drags on? A Systematic Review and Meta-Analysis. Breast Cancer Research and Treatment, 185, 21-37. https://doi.org/10.1007/s10549-020-05924-8
[13]
Ait, I., Bourhafour, M., Haffadi, M., Bouchbika, Z., Benchakroune, N., Jouhadi, H., etal. (2022) Quelle chimiothérapie dans les tumeurs phyllodes métastatiques du sein? rapport de cas. Pan African Medical Journal, 42, Article 293. https://doi.org/10.11604/pamj.2022.42.293.20377
[14]
Chellakhi, M., Benchakroun, N., Bouchbika, Z., Jouhadi, H., Tawfiq, N., Sahraoui, S., et al. (2018) Radiothérapie des sarcomes mammaires primitifs: étude rétrospective. Cancer/Radiothérapie, 22, 211-215. https://doi.org/10.1016/j.canrad.2017.12.003
[15]
Al-Benna, S., Poggemann, K., Steinau, H. and Steinstraesser, L. (2010) Diagnosis and Management of Primary Breast Sarcoma. Breast Cancer Research and Treatment, 122, 619-626. https://doi.org/10.1007/s10549-010-0915-y
[16]
Zelek, L., Llombart-Cussac, A., Terrier, P., Pivot, X., Guinebretiere, J.M., Le Pechoux, C., et al. (2003) Prognostic Factors in Primary Breast Sarcomas: A Series of Patients with Long-Term Follow-Up. Journal of Clinical Oncology, 21, 2583-2588. https://doi.org/10.1200/jco.2003.06.080
[17]
Bishr, M.K. (2024) Contemporary Management of Phyllodes Tumours of the Breast: Recommendations from the UK Association of Breast Surgery. British Journal of Surgery, 112, znae277.
[18]
Asoglu, O., Ugurlu, M.M., Blanchard, K., Grant, C.S., Reynolds, C., Cha, S.S., et al. (2004) Risk Factors for Recurrence and Death after Primary Surgical Treatment of Malignant Phyllodes Tumors. Annals of Surgical Oncology, 11, 1011-1017. https://doi.org/10.1245/aso.2004.02.001
