Surgical treatment and MRI in phyllodes tumors of the breast: our experience and review of the literature.

Aims: To reassess the relationship between magnetic resonance imaging (MRI) findings and surgical resection margins in an attempt to address the issue of appropriate surgical management of phyllodes tumors (PT).

Methods: Three female patients with a large palpable mass suspicious for phyllodes tumors were studied by mammography (MX), ultrasound (US) and dynamic MRI and then underwent surgery.

Results: MRI demonstrated a rapidly and markedly enhancing multi-lobulated lesion. T1-weighted and T2-weighted sequences showed inhomogeneous signal intensity for the presence of cystic areas with internal septation and hemorrhage. Some areas of linear enhancement were present around the mass only in one case. Surgical management was mastectomy in one patient and wide excision in the other two patients. The margins in one of the latter patients were not clear, so mastectomy with immediate prosthetic reconstruction was subsequently performed. Pathological results showed 1 case of benign phylloides tumor, 1 case of borderline phylloides tumor and 1 case of malignant phylloides tumor.

Conclusions: MRI enabled complete visualization of the tumor even in the region close to the chest wall, as well as clear delineation from healthy glandular tissue and may help to define the appropriate surgical management of phylloides tumor.