Management of Phyllodes Tumor of the Breast: A Single Centre Experience

Al-Ishaq, Zaid R.; AlAghbari, Suad; Al Hattali, Samiya; AlRiyami, Marwa; AlAjmi, Radhiya; AlQassabi, Badriya S.; Trehan, Arti; Akhter, Syed; Al Baimani, Khalid; Al-Ajmi, Adil Al Jarrah

doi:10.33091/amj.2026.167170.2519

	Management of Phyllodes Tumor of the Breast: A Single Centre Experience
Al- Anbar Medical Journal
Volume 22, Issue 2, April 2026, Pages 95-100 PDF (326.3 K)
Document Type: Original articles
DOI: 10.33091/amj.2026.167170.2519
Authors
Zaid R. Al-Ishaq^* ¹; Suad AlAghbari¹; Samiya Al Hattali²; Marwa AlRiyami³; Radhiya AlAjmi³; Badriya S. AlQassabi⁴; Arti Trehan⁵; Syed Akhter⁵; Khalid Al Baimani⁶; Adil Al Jarrah Al-Ajmi¹
¹Department of Surgical Oncology, Breast Program, Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC)/University Medical City, Muscat, Sultanate of Oman.
²Department of Surgery, Nizwa Hospital, Nizwa, Sultanate of Oman.
³Pathology Department, Sultan Qaboos University Hospital, University Medical City and College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman.
⁴Department of Radiology and Nuclear Medicine, Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC)/University Medical City, Muscat, Sultanate of Oman.
⁵Department of Histopathology, Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC)/University Medical City, Muscat, Sultanate of Oman.
⁶Department of Medical Oncology, Breast Program, Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC)/ University Medical City, Muscat, Sultanate of Oman.
Abstract
Background: Phyllodes tumors (PT) are rare fibroepithelial neoplasms of the breast that represent 0.3% to 1% of all primary breast tumors and may occur in benign, borderline or malignant forms. Objectives: To describe the clinical characteristics, surgical management, and outcomes of PT treated at a tertiary center in Oman. Materials and Methods: A retrospective review of all PT cases managed between 2011 and 2024 at the Breast Program of Sultan Qaboos Comprehensive Cancer Care and Research Centre/University Medical City was conducted. Demographic, pathological, surgical, adjuvant treatment, and outcome data were analyzed. Results: Seventeen Omani women were identified. Histological subtypes included malignant in 9 patients (52.9%), borderline in 6 (35.2%), and benign in 2 (11.7%). Breast-conserving surgery was performed in 13 patients (76.4%); 9 required re-excision for margin clearance, and 1 declined further surgery. Axillary staging was performed in 8 patients (47.1%) due to clinically suspicious nodes, with no pathological involvement detected. Adjuvant radiotherapy was administered to 3 patients (17.6%) with malignant PT. During a mean follow-up of 5.4 years (range 1-13 years), local recurrence occurred in 2 patients (11.7%) and distant metastases in 4 patients (23.5%). Conclusions: PT in this cohort frequently required margin re-excision, highlighting the importance of maintaining a high index of suspicion, integrating oncoplastic surgical techniques, and adopting a multidisciplinary management approach. Selective axillary assessment based on preoperative evaluation and multidisciplinary discussion may help minimize unnecessary axillary surgery.
Keywords
Phyllodes tumor; Breast; Management

References
[1] N. Balalaa et al., "Malignant Phyllodes tumor: A Multi-Tertiary Institutions retrospective analysis–United Arab Emirates (UAE) Experience," European Journal of Surgical Oncology, vol. 49, no. 2, p. e66, 2023. [2] A. Toussaint, R. Piaget-Rossel, C. Stormacq, P. Mathevet, K. Lepigeon, and P. Taffe, "Width of margins in phyllodes tumors of the breast: the controversy drags on?—a systematic review and meta-analysis," Breast cancer research and treatment, vol. 185, no. 1, pp. 21-37, 2021. [3] W. C. o. T. E. Board, "WHO classification of tumours: breast tumours," ed: International Agency for Research on Cancer Lyon, 2019. https://publications.iarc.fr/581 [4] L. Bernstein, D. Deapen, and R. K. Ross, "The descriptive epidemiology of malignant cystosarcoma phyllodes tumors of the breast," Cancer, vol. 71, no. 10, pp. 3020-3024, 1993. [5] N. P. Gullett, M. Rizzo, and P. A. Johnstone, "National surgical patterns of care for primary surgery and axillary staging of phyllodes tumors," The breast journal, vol. 15, no. 1, pp. 41-44, 2009. [6] G. Spitaleri et al., "Breast phyllodes tumor: a review of literature and a single center retrospective series analysis," Critical reviews in oncology/hematology, vol. 88, no. 2, pp. 427-436, 2013. [7] W. J. Gradishar et al., "Breast cancer, version 3.2024, NCCN clinical practice guidelines in oncology," Journal of the National Comprehensive Cancer Network, vol. 22, no. 5, pp. 331-357, 2024. [8] M. K. Bishr et al., "Contemporary management of phyllodes tumours of the breast: recommendations from the UK Association of Breast Surgery," British Journal of Surgery, vol. 112, no. 8, p. znaf152, 2025. [9] P. H. Tan, G. M.-K. Tse, G. W.-C. Yip, and B. H. Bay, "Phyllodes tumors of the breast: the role of immunohistochemistry in diagnosis," in Methods of Cancer Diagnosis, Therapy and Prognosis: Breast Carcinoma: Springer, pp. 251-262, 2008. [10] J. Li et al., "Predicting outcome in mammary phyllodes tumors: relevance of clinicopathological features," Annals of surgical oncology, vol. 26, no. 9, pp. 2747-2758, 2019. [11] G. A. Demian et al., "Phyllodes tumors of the breast: Analysis of 35 cases from a single institution," Journal of the Egyptian National Cancer Institute, vol. 28, no. 4, pp. 243-248, 2016. [12] A. Alkushi et al., "Phyllodes tumor of the breast clinical experience and outcomes: A retrospective cohort tertiary hospital experience," Annals of Diagnostic Pathology, vol. 51, p. 151702, 2021. [13] H. Assi, R. Salem, F. Sukhon, J. Abbas, F. Boulos, and N. E. Saghir, "Phyllodes tumors of the breast treated in a tertiary health care center: case series and literature review," Journal of International Medical Research, vol. 48, no. 1, p. 0300060518803530, 2020. [14] M. H. Ibreaheem, S. Naguib, M. Gamal, R. Boutrus, M. M. M. Gomaa, and O. Talaat, "Phyllodes tumors of the breast (the Egyptian experience)," Indian Journal of Surgical Oncology, vol. 11, no. 3, pp. 423-432, 2020. [15] M. Yen-Fa Toh MBBS, M. Phaik-Leng Cheah, and M. Kean-Hooi Teoh MBChB, "Phyllodes tumours of the breast: retrospective analysis of a University Hospital's experience," The Malaysian journal of pathology, vol. 38, no. 1, p. 19, 2016. [16] C. Sars et al., "Current clinical practice in the management of phyllodes tumors of the breast: an international cross-sectional study among surgeons and oncologists," Breast cancer research and treatment, vol. 199, no. 2, pp. 293-304, 2023. [17] B. Sain et al., "Clinico-pathological factors determining recurrence of phyllodes tumors of the breast: the 25-year experience at a tertiary cancer centre," Journal of Personalized Medicine, vol. 13, no. 5, p. 866, 2023. [18] G. Z. Li, C. P. Raut, K. K. Hunt, M. Feng, and R. Chugh, "Breast Sarcomas, Phyllodes Tumors, and Desmoid Tumors: Epidemiology, Diagnosis, Staging, and Histology-Specific Management Considerations," in American Society of Clinical Oncology Educational book. American Society of Clinical Oncology. Annual Meeting, vol. 41, pp. 390-404, 2021. [19] Y. Lu et al., "Local Recurrence of Benign, Borderline, and Malignant Phyllodes Tumors of the Breast: A Systematic Review and Meta-analysis: Y. Lu et al," Annals of surgical oncology, vol. 26, no. 5, pp. 1263-1275, 2019. [20] C. K. Yom, W. Han, S.-W. Kim, S. Y. Park, I. A. Park, and D.-Y. Noh, "Reappraisal of conventional risk stratification for local recurrence based on clinical outcomes in 285 resected phyllodes tumors of the breast," Annals of surgical oncology, vol. 22, no. 9, pp. 2912-2918, 2015. [21] C. Atalay, V. Kınaş, and S. Çelebioğlu, "Analysis of patients with phyllodes tumor of the breast," Turkish Journal of Surgery/Ulusal cerrahi dergisi, vol. 30, no. 3, p. 129, 2014. [22] C. Rutherford, S. Barker, and L. Romics, "A systematic review of oncoplastic volume replacement breast surgery: oncological safety and cosmetic outcome," The Annals of The Royal College of Surgeons of England, vol. 104, no. 1, pp. 5-17, 2022. [23] T. Adesoye, H. B. Neuman, L. G. Wilke, J. R. Schumacher, J. Steiman, and C. C. Greenberg, "Current trends in the management of phyllodes tumors of the breast," Annals of surgical oncology, vol. 23, no. 10, pp. 3199-3205, 2016. [24] V. C. Y. Koh, A. A. Thike, and P. H. Tan, "Distant metastases in phyllodes tumours of the breast: an overview," Applied Cancer Research, vol. 37, no. 1, p. 15, 2017. [25] R. J. Barth Jr, W. A. Wells, S. E. Mitchell, and B. F. Cole, "A prospective, multi-institutional study of adjuvant radiotherapy after resection of malignant phyllodes tumors," Annals of surgical oncology, vol. 16, no. 8, pp. 2288-2294, 2009. [26] S. Zeng, X. Zhang, D. Yang, X. Wang, and G. Ren, "Effects of adjuvant radiotherapy on borderline and malignant phyllodes tumors: A systematic review and meta‑analysis," Molecular and clinical oncology, vol. 3, no. 3, pp. 663-671, 2015. [27] C.-Y. Yu, T.-W. Huang, and K.-W. Tam, "Management of phyllodes tumor: A systematic review and meta-analysis of real-world evidence," International Journal of Surgery, vol. 107, p. 106969, 2022. [28] A. J. Hayes et al., "UK guidelines for the management of soft tissue sarcomas," British journal of cancer, vol. 132, no. 1, pp. 11-31, 2025. [29] M. L. Telli, K. C. Horst, A. E. Guardino, F. M. Dirbas, and R. W. Carlson, "Phyllodes tumors of the breast: natural history, diagnosis, and treatment," Journal of the National Comprehensive Cancer Network, vol. 5, no. 3, pp. 324-330, 2007.
Statistics Article View: 297 PDF Download: 329