Incidence Proportion and Clinicopathological Characteristics of Phyllodes Tumors of the Breast Among Patients With Breast Lumps in Dubai, 2017-2022: A Retrospective Observational Study

Abstract

Background: Phyllodes tumors are rare fibroepithelial neoplasms of the breast, with histological behavior ranging from benign to malignant. Published data from the Middle East are limited. Objective: This study aimed to determine the incidence proportion and clinicopathological characteristics of phyllodes tumors among patients presenting with breast lumps at a tertiary care center in Dubai between 2017 and 2022. Methods: This retrospective observational study included all female patients who presented with a breast lump to Dubai Hospital between January 2017 and December 2022 and underwent biopsy or surgical excision, with histopathology results available. The source population comprised 1,680 breast lump cases. Histologically confirmed phyllodes tumors constituted the analytic cohort. Variables analyzed included age, body mass index (BMI), tumor size, WHO histological subtype, margin status, surgical management, and 24-hour local recurrence. The incidence proportion was calculated with 95% confidence intervals using the Wilson score method. Fisher’s exact tests were used to explore associations between clinicopathological factors and recurrence; all tests used a prespecified significance threshold of α = 0.05. Results: Twenty-four phyllodes tumors were identified among 1,680 breast lump presentations (incidence proportion: 1.43%; 95% CI: 0.89-2.10%). WHO subtypes were equally distributed: benign (n = 8, 33.3%), borderline (n = 8, 33.3%), and malignant (n = 8, 33.3%). The mean age was 41.7 years (SD 11.1), and the mean tumor size was 11.1 cm (SD 9.9). Negative surgical margins were achieved in 11/24 cases (45.8%). Preoperative core biopsy confirmed phyllodes tumors in only 5/24 patients (20.8%). Local recurrence within 24 months occurred in 2/24 patients (8.3%; 95% CI: 1.0-26.0%), both of whom had borderline or malignant tumors. Conclusion: Phyllodes tumors comprised 24/1,680 (1.43%) of surgically evaluated breast lumps at this tertiary care center in Dubai, an estimate exceeding the commonly cited global reference range of 0.3-1%, although direct comparison is limited by differences in denominator definition. These findings represent the first incidence proportion data for phyllodes tumors from the Dubai region and highlight diagnostic challenges, an atypical subtype distribution, and a low short-term recurrence rate, collectively informing risk-adapted surgical management in a diverse Middle Eastern population.