Local recurrence occurred in 5 patients, each of whom had positive margins or margins less than 1 cm after excision. After reexcision with a 1-cm margin, these individuals remained free of recurrence. One patient developed metastatic disease after total mastectomy and died after chemotherapy. Conclusions Phyllodes tumors mimic fibroadenomas and are often excised with close margins. Primary excision or reexcision with a 1-cm margin is recommended.
Mastectomy is indicated for patients with large lesions.
Lymph node metastases are unusual and occur secondary to necrotic tumor. Chemotherapy is based on guidelines for the treatment of sarcomas, not breast adenocarcinoma. From the Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston. Presented at the 79th Annual Meeting of the New England Surgical Society, Toronto, Ontario, September 26, 1998. All rights reserved.