3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item The rate and risk factors for local recurrence of phyllodes tumours in a South African population(2019) Spinks, JaniceBackground: Phyllodes tumours are rare fibroepithelial neoplasms of the breast. The dilemma with phyllodes tumours is their tendency to local recurrence. This retrospective review of phyllodes tumours in a South African population aims to describe the most common histological and clinical features, and describe the clinical and histological risk factors for local recurrence. Methods: All histological reports of patients diagnosed with a phyllodes tumour after surgery at the University of the Witwatersrand Anatomical Pathology Laboratories in Johannesburg were assessed from 1 January 2005 to 30 June 2016. Clinical and histological parameters were analysed. Results: Over the study period, 185 patients were identified. The median age of the patients was 42 years. There were 89 (48.1%) patients with a benign tumour, 34 (18.4%) with a borderline tumour and 62 (33.5%) with a malignant tumour. The size of the tumours ranged from 11 to 460mm, with a median of 85.0mm 79.6 SD. Breast conserving surgery (BCS) was performed on 64.3% of patients and 35.7% of patients had a mastectomy. There was an overall local recurrence rate of 3.78% (2.2% for benign and 8.1% for malignant tumours). No clinical or histological factors, including margin status, were found to significantly predict local recurrence. Most recurrences (71.4%, n=5) occurred within the first two years. Conclusion: Our study did not find any predictors of local recurrence, but we provide further support to the recent suggestion of revising the common practice of wide local excision with a 1cm margin, to an excision with negative margins combined with close follow-up for two years.