Phyllodes tumor of the breast: Race-related differences in presentation, pathology and prognosis

Abstract

Purpose

We aimed to investigate the race-related differences in clinical, radiological, and pathological presentation and prognosis of phyllodes tumors (PTs).

Methods

This retrospective cohort study included patients diagnosed with PTs from 5/1/2012 to 5/31/2022. Pathology reports, radiology findings, and clinical data were extracted from electronic medical records. Statistical analysis assessed these differences across racial demographics.

Results

Among 62 women with PTs (mean age: 41 ± 15.2 years), the racial distribution was 21 % Caucasian, 32 % African American, 17.7 % Hispanic, and 29 % Asian/Other. Minority women were significantly more likely to present with palpable masses than Caucasian patients (p = 0.031), suggesting potential disparities in early detection. Minority patients were more likely to be covered by Medicaid and reside in lower-income ZIP codes, with a higher proportion under age 40 at presentation, though these results were not statistically significant. While tumor size varied by race, this difference was also not statistically significant (p = 0.094). Pathologically, 66.1 % of tumors were benign, 22.6 % borderline, and 11.3 % malignant. Although lumpectomy was the preferred approach across all racial groups, no Caucasian or Hispanic patients undergoing mastectomy. No significant racial differences were observed in resection margins (p = 0.263), re-excision rates (p = 0.503), or recurrence rates (p = 0.238).

Conclusion

Minority women had a higher likelihood of presenting with symptomatic PTs, underscoring potential disparities in screening. While treatment outcomes were similar across racial groups, targeted screening efforts in at-risk populations may improve early detection and promote equitable healthcare access.