Recurrent Phyllodes Tumor of the Breast: Defining the Role for Skin-Sparing Mastectomy and Autologous Reconstruction

Mohamed Anwar Atalla; Warren Matthew Rozen; Damien Grinsell; Anthony Hyett; Saurabh Prakash; Alvin Cham

doi:10.1055/s-0031-1275493

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2011; 27(4): 267-272
DOI: 10.1055/s-0031-1275493

Recurrent Phyllodes Tumor of the Breast: Defining the Role for Skin-Sparing Mastectomy and Autologous Reconstruction

Mohamed Anwar Atalla¹ , Warren Matthew Rozen¹ , Damien Grinsell¹ , Anthony Hyett¹ , Saurabh Prakash¹ , Alvin Cham¹

¹Department of Surgery, Western Hospital, Footscray, Victoria, Australia

Abstract

ABSTRACT

Phyllodes tumors (PTs) are uncommon fibroepithelial tumors of the breast, noteworthy for their difficult excisions and high recurrence rates. In the setting of recurrence, there is no consensus in the literature as to the extent of excision or the impact on reconstructive options. Breast-conserving surgery and simple mastectomy have each been described with mixed reports. Despite a shift toward the selective use of skin-sparing mastectomy and nipple-areola complex–sparing mastectomy in breast carcinoma, neither the role for these techniques nor the role for breast reconstruction in recurrent PT has been described. A case report is presented demonstrating the utility of skin-sparing mastectomy and autologous breast reconstruction for locally recurrent PT of the breast, with a literature review of management options in this setting presented. The case presented highlights an appropriate setting for autologous microsurgical reconstruction of the breast in recurrent PT. The literature review highlights a lack of any published management consensus, with only the role for mastectomy suggested for recurrent high-grade or malignant lesions. A potential management algorithm is thus presented. Skin-sparing mastectomy, particularly for intermediate-grade lesions, may allow wider resections while enabling aesthetically pleasing reconstructive options without affecting recurrence rates.

KEYWORDS

Phyllodes tumor - cystosarcoma - breast - skin sparing mastectomy - reconstruction

Full Text

References

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Warren Matthew RozenM.B.B.S. B.Med.Sc. P.G.Dip.Surg.Anat. Ph.D.

Department of Surgery

Western Hospital, Footscray, Victoria, Australia

Email: warrenrozen@hotmail.com