INTRODUÇÃO: Os tumores phyllodes borderline e maligno da mama apresentam tendência a rápido crescimento e possibilidade de evolução com metástases à distância. Exérese cirúrgica da lesão é o tratamento padrão-ouro, não havendo papel claro para as terapias adjuvantes na condução desses tumores. Foram avaliados dados epidemiológicos, clinicopatológicos e de tratamento, bem como os desfechos das pacientes com tumor phyllodes borderline e maligno acompanhadas em nossas instituições. MÉTODOS: Coorte retrospectiva com análise de dados coletados em prontuário com seguimento de janeiro de 2007 a dezembro de 2018, incluindo variáveis clínicas, patológicas e de seguimento, além de análise de fatores de risco e sobrevida. RESULTADOS: Foram incluídas no estudo 22 pacientes com tumor phyllodes borderline e 29 com tumor phyllodes maligno. Tumores malignos apresentaram maiores dimensões (p=0.013) e foram mais frequentemente tratados com mastectomia (p=0.007). Cirurgia conservadora (p=0.010), margens cirúrgicas comprometidas (p=0.020) e ausência de radioterapia adjuvante (p=0.002) foram associados com aumento de recidiva local. Na análise multivariada, pacientes que realizaram radioterapia apresentaram menor recidiva (aHR=0.06; IC95% 0.01-0.33). Pior sobrevida livre de doença foi observada nas pacientes com margens cirúrgicas comprometidas (p=0.034), pleomorfismo acentuado (p=0.045), necrose (p=0.048), e naquelas não submetidas à radioterapia (p=0.010). CONCLUSÃO: A realização de radioterapia adjuvante atuou como fator protetor, reduzindo o risco de recidiva local na coorte geral de tumores phyllodes e no subgrupo de tumores phyllodes malignosbreast disease; Breast diseases; Breast neoplasms.

INTRODUCTION: Borderline and malignant phyllodes tumor of the breast tend to grow rapidly and may progress with distant metastases. Surgical excision of the lesion is the gold standard treatment, with no clear role for adjuvant therapies in the management of these tumors. Epidemiological, clinicopathological and treatment data were evaluated, as well as outcomes of patients diagnosed with borderline and malignant phyllodes tumor of the breast followed at our institutions. METHODS: Retrospective cohort with analysis of data collected from medical records, with follow-up from January 2007 to December 2018, including clinical, pathological and follow-up variables, in addition to the analysis of risk factors and survival. RESULTS: 22 patients with borderline phyllodes tumor and 29 with malignant phyllodes tumor were included in the study. Malignant tumors had larger dimensions (p=0.013) and were more frequently treated with mastectomy (p=0.007). Conservative surgery (p=0.010), positive surgical margins (p=0.020) and absence of adjuvante radiotherapy (p=0.002) were associated with increased local recurrence. In multivariate analysis, patients who underwent radiotherapy showed less recurrence (aHR=0.06; IC95% 0.01-0.33). Worse disease-free survival was observed in patients with positive surgical margins (p=0.034), marked pleomorphism (p=0.045), necrosis (p=0.048) and in those not submitted to radiotherapy (p=0.010). CONCLUSION: Adjuvant radiotherapy acted as a protective factor, reducing the risk of local recurrence in the gerenal cohort of phyllodes tumors and in the subgroup of malignant phyllodes tumors