Management of Phyllodes Tumor of the Breast: A Single Centre Experience

Background: Phyllodes tumors (PT) are rare fibroepithelial neoplasms of the breast that represent 0.3% to 1% of all primary breast tumors and may occur in benign, borderline or malignant forms. Objectives: To describe the clinical characteristics, surgical management, and outcomes of PT treated at a tertiary center in Oman. Materials and Methods: A retrospective review of all PT cases managed between 2011 and 2024 at the Breast Program of Sultan Qaboos Comprehensive Cancer Care and Research Centre/University Medical City was conducted. Demographic, pathological, surgical, adjuvant treatment, and outcome data were analyzed. Results: Seventeen Omani women were identified. Histological subtypes included malignant in 9 patients (52.9%), borderline in 6 (35.2%), and benign in 2 (11.7%). Breast-conserving surgery was performed in 13 patients (76.4%); 9 required re-excision for margin clearance, and 1 declined further surgery. Axillary staging was performed in 8 patients (47.1%) due to clinically suspicious nodes, with no pathological involvement detected. Adjuvant radiotherapy was administered to 3 patients (17.6%) with malignant PT. During a mean follow-up of 5.4 years (range 1-13 years), local recurrence occurred in 2 patients (11.7%) and distant metastases in 4 patients (23.5%). Conclusions: PT in this cohort frequently required margin re-excision, highlighting the importance of maintaining a high index of suspicion, integrating oncoplastic surgical techniques, and adopting a multidisciplinary management approach. Selective axillary assessment based on preoperative evaluation and multidisciplinary discussion may help minimize unnecessary axillary surgery.