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

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
Further Information

Publication History

Received: October 19, 2010. Accepted: January 12, 2011.

Publication Date:
22 March 2011 (online)

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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

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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

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