Phyllodes Tumour of the Female Breast in Two District Hospitals in Abuja, Northcentral Nigeria: A Ten-Year Review of Clinicopathological Features and Management Outcome
Keywords:
Phyllodes Tumor; Breast; Clinicopathological Features; Management Outcome; Abuja.Abstract
Background: Phyllodes tumours (PT) of the breast are rare fibroepithelial tumours which are often indistinguishable from fibroadenomas and commonly affect women aged 35 to 55 years. PTs are a spectrum of tumours that range from benign and borderline to malignant subtypes. Preoperative histological diagnosis is often a challenge but key to optimal surgical management, which is the mainstay of treatment. Postoperative histopathological examination of surgical specimen and frequent clinical audit of cases are important in identifying the disease burden.
Aim: The aim of the study was to retrospectively review the clinicopathological features and management outcome of phyllodes tumours managed in two public secondary-level healthcare facilities in Abuja, North-central Nigeria.
Materials and Method: The study involved a review and analysis of all cases of histologically diagnosed phyllodes tumours of the female breast managed at the departments of surgery by 2 district hospitals over a 10-year period, between June 2014 and May 2024.
Results: A total of 857 patients were managed for breast tumours in both hospitals within the study period. Of these, 54 cases representing 6.3% were phyllodes tumours of the female breast. The patients’ age ranged from 14-57 years (mean age of 32.1 years). A biphasic peak frequency was noted in the 14-20 years and the 31-40 years age range. More than 50% of the patients were below age 30 years [30(55.5%)]. Most of the tumours, 32(59.2%) were located in the right breast and 4(7.4%) were bilateral. Majority of the tumours, 45(83.3%) were benign, 4(7.4%) were borderline, while 5(9.3%) were malignant. 60% of those with the malignant subtype were aged over 50 years. Majority, 30(55.5%), measured <5 cm in the widest diameter. The mean tumour weight was 510.4 g. Surgical management was employed in all cases with either wide local excision or mastectomy. Overall, management outcome was favourable.
Conclusion: This study found a predominance of benign disease, a dual peak and high incidence of PT among the younger age group with older patients affected by the malignant subtypes. Accurate preoperative histological diagnosis and institution of appropriate surgical management are necessary in reducing the risk of recurrence.
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