JOURNAL OF CANCER & ALLIED SPECIALTIES 1 ORIGINAL ARTICLE J Cancer Allied Spec 2016;2(1):6 PHYLLODES TUMOUR: A REVIEW OF AN UNCOMMON BREAST PATHOLOGY AT A SPECIALISED CANCER CENTRE Samiullah K. Niazi 1 , Raza Sayyed 2 , Muhammad Z. Chaudhry 2 , Amina I. Khan 2 , Huma M. Khan 2 , Shahida Bibi 2 1 Department of Surgery, Dow University of Health Sciences, Karachi, Pakistan, 2 Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan Received: 1 January 2015 / Accepted: 1 April 2016 Abstract Purpose: Phyllodes tumours are rare breast tumours that comprise almost 1% of breast tumours. The outcome for these tumours is generally considered better than breast cancers. We review the cases of phyllodes tumour presenting to a specialised cancer centre over a 14-year period. Materials and Methods: All case records with the diagnosis of phyllodes tumour between 1999 and 2012 were retrieved from the cancer registry. Patient demographics, tumour site, size, axillary lymph node status, whether primary or recurrent, metastatic status, histological type, type of surgery, any complication, margin positivity, post- operative radiation therapy, local or distant recurrence, morality and follow-up duration were recorded. Data were analysed using SPSS. Results: A total of 77 cases of phyllodes tumour were seen between 1999 and 2012. All patients were female with a mean age of 39.9 years. All patients presented with a breast lump with median duration of 8 months. Almost two-thirds (65%) of the patients presented with primary tumour compared to 10% recurrent tumours and the rest were referred after surgery outside. Median size on histopathology was 5 cm (IQR 3.5–8.5 cm). Over a median follow-up duration of 31 months (IQR 9–48 months), 69 patients (89.6%) were alive, while 3 patients (3.9%) did not survive and 5 patients (6.4%) were lost to follow-up. Recurrence was seen in 10 (13%) patients with median time to recurrence of 12 months (IQR 7–24). Involved axillary lymph nodes and borderline or malignant histopathology were found to be signifcantly associated with recurrence (P = 0.04), while margin positivity, post-operative radiation therapy and histopathology were not signifcantly associated with recurrence. Conclusion: Phyllodes tumour is an uncommon breast tumour that is predominantly treated with surgical excision. Although survival with these tumours is better compared to breast cancers, involvement of axillary nodes and borderline or malignant histopathology confer an increased risk of recurrence in these patients. Key words: Breast cancer, phyllodes tumours, survival Correspondence: Dr. Samiullah K. Niazi, Department of Surgery, Dow University of Health Sciences, Karachi, Pakistan. Email: drsami80@hotmail.com Introduction Phyllodes tumour or cystosarcoma phyllodes is a rare breast lesion comprising <1% of all breast tumours. [1,2] The usual presentation is a rapidly enlarging mass in a young female, which is often misdiagnosed and treated as fbroadenoma. Quite often, the diagnosis is revealed on histopathology of a presumed fbroadenoma after excision. Pathologically, it varies from benign to borderline or malignant form depending on its size and histological features including mitotic rates. [3] Opinion varies in literature regarding the treatment options, adequate resection margins and role of radiation therapy in prevention of recurrence in this disease. [4-6] There is still controversy about the biological behaviour of borderline and malignant tumours in terms of survival and recurrence. The most universally acceptable classifcation system based on pathological features for phyllodes tumours is