Metastatic Malignant Phyllodes Tumor of the Breast: An Aggressive Disease—Analysis of 7 Cases

Malignant phyllodes tumor (PT) of the breast behaves aggressively and the presentation of distant metastases is varied, ranging from synchronous or short interval commonly to a decade rarely. To assess the clinical and temporal pattern of distant metastases in malignant PTs. A retrospective analysis of patients with Phyllodes tumor of the breast from January, 2001 to November, 2014. There were a total of 167 patients with PT; 49 (29 %) were malignant PT out of which 7 developed distant metastases. Detailed analysis of these 7 patients showed that mean age was 36.71 years (range 28–53 years). Three of the seven patients had additional local recurrences post lumpectomy. The procedure performed were wide local excision with muscle reconstruction (n = 1), lumpectomy (n = 1) and mastectomy (n = 5). The distant metastases were synchronous (n = 2) and other 5 had metastases developing within 2 months to 13 years. The sites for distant metastases included lung, brain, adrenal, para-aortic nodes and bone. Six patients received palliative chemotherapy (CT) and 2 also had radiation therapy for brain metastasis. Only 1 patient is alive and receiving CT and all others succumbed to the disease. Patients with malignant PT of the breast with distant metastases behave aggressively and have a dismal outcome with rare exceptions. They need multimodality therapy and close follow up. Newer targeted therapies may have a role to improve the outcome.