Local Recurrence of Benign, Borderline, and Malignant Phyllodes Tumors of the Breast: A Systematic Review and Meta-analysis

Lu, Yiwen; Chen, Yanbo; Zhu, Liling; Cartwright, Paul; Song, Erwei; Jacobs, Lisa K.; Chen, Kai

doi:10.1245/s10434-018-07134-5

Cited by 121 publications

(139 citation statements)

References 64 publications

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“…The pooled LR rate for patients who underwent both radiotherapy and surgery was (8%, 95% CI: 1-22%). These data were lower than both our calculated LR rate of 19% (95% CI: 7-18%) and the pooled LR rates of borderline (13%) and malignant (18%) reported by a meta-analysis [33]. Furthermore, the results of our subgroup analysis suggested that irradiation may be more effective in younger patients (< 45 years), patients with larger tumors, patients with malignant tumors and patients with wider excision.…”

Section: Discussioncontrasting

confidence: 88%

Adjuvant radiotherapy and chemotherapy for patients with breast phyllodes tumors: a systematic review and meta-analysis

Xue

Chen

Zeng³

et al. 2019

BMC Cancer

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Background: As the efficacy of radiotherapy and chemotherapy for treatment of phyllodes tumors (PTs) remains unclear, this study aimed to review all available data and evaluate the roles of radiotherapy and chemotherapy in PT treatment. Methods: We performed a comprehensive search of databases, including PubMed, Web of Science and the Cochrane Library. The outcomes of interest included the local recurrence (LR) rate, metastasis rate, disease-free survival rate and overall survival rate. Results: Seventeen studies enrolling 696 patients were included in this random effect meta-analysis. Subgroup analysis and meta-regression were also conducted to determine study heterogeneity. A pooled local recurrence rate of 8% (95% CI: 1-22%) was observed with a statistical heterogeneity of I 2 = 86.6% (p < 0.01) for radiotherapy. This was lower than the recurrence rate of 12% for simple surgical treatment (95% CI: 7-18%). Meta-regression analysis found that surgical margin status was the main source of heterogeneity (p = 0.04). The metastasis rate of 4% (95% CI: 0-11%) for patients receiving radiotherapy without significant heterogeneity was also lower than the rate for the simple surgery group (8, 95% CI: 3-15%). The available data for chemotherapy were too limited to support meta-analysis. Accordingly, we offer a pure review of these data. Conclusion: Our findings suggest that radiotherapy is effective in achieving local disease control and preventing metastasis.

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Section: Discussioncontrasting

confidence: 88%

Adjuvant radiotherapy and chemotherapy for patients with breast phyllodes tumors: a systematic review and meta-analysis

Xue

Chen

Zeng³

et al. 2019

BMC Cancer

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“…Patients with PT usually present with round, mobile and painless breast lumps, which are more commonly in the upper outer quadrant with equal chance of the two breasts to be involved [ 5 ]. About 20% of the patients have palpable axillary lymphadenopathy and a significant proportion of the patients have history of fibroadenoma with up to 20% of them being with high local recurrence rate [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…This shows that the tendency of PTs to recur locally increases with increase in aggressiveness of the tumour. The study also reported that mitoses, tumour border, stromal cellularity, stromal atypia, stromal overgrowth and tumour necrosis can independently predict development of local recurrence [ 5 ]. The categorization of PTs into benign, borderline and malignant was described in the study by Salvadori et al .…”

Section: Discussionmentioning

confidence: 99%

Recurrent giant phyllodes tumour in a 17-year-old female: a rare case report

Yahaya

2020

Oxford Medical Case Reports

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Phyllodes tumours (PTs) are rare fibroepithelial tumours of the breast with incidence accounting for <1% in the general population. Availability of reports on PTs with size of 31 cm or more in diameter in the literature are extremely rare. Herein, the case of a 17-year-old female patient with a giant recurrent right breast PT is reported. Histologically, the tumour showed proliferation of stromal tumour cells consisting of spindle cells with uniform nuclear chromatin, inconspicuous nucleoli, abundant eosinophilic cytoplasm and proliferation labelling index for Ki67 of <10%. PTs require meticulous surgical excision due to the fact that they have a high rate of recurrence and status of surgical margins must be included in the pathology report. This is because recurrent cases of PTs tend to grow faster than the primary ones with a high chance of transforming to malignancy.

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“…Die Lokalrezidivrate von Phylloides-Tumoren hängt von verschiedenen Faktoren ab. In einer Metaanalyse über 54 Studien mit 9234 Fällen betrug sie bei benignen PT 8 %, bei Borderline 13 % und malignen PT 18 % [5].…”

Section: Lokalrezidiveunclassified

“…Histopathologische Faktoren, die mit einem erhöhten Risiko für Lokalrezidive einhergehen, sind Mitosen, infiltrierendes vs. verdrängendes Tumorwachstum, stromale Atypie, stromale Überwucherung und Tumornekrosen [5].…”

Section: Lokalrezidiveunclassified

Zur Therapie von Phylloides-Tumoren der Brust – eine Aufarbeitung von 66 Fällen mit Literaturübersicht

Lohmeyer¹,

Huster²,

Lühr

et al. 2020

Handchir Mikrochir Plast Chir

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ZusammenfassungPhylloides-Tumore (PT) der Brust werden anhand der Konstellation definierter histologischer Parameter als benigne, borderline und maligne klassifiziert. Die chirurgische Exzision ist die primäre Therapie, aber die Notwendigkeit zur Einhaltung bestimmter Sicherheitsabstände wird für alle drei Kategorien kontrovers diskutiert. Ziel der Arbeit ist eine kritische Stellungnahme zur bestehenden Empfehlung zu Sicherheitsabständen der Resektion.In unserem Brustzentrum wurden retrospektiv anhand der histopathologischen Dokumentationen von 1999 bis 2018 alle Patientinnen mit Phylloides-Tumoren identifiziert und die Fälle insbesondere hinsichtlich des Auftretens von Rezidiven und Multizentrizität ausgewertet.Insgesamt wurde bei 66 Patientinnen die Diagnose eines PT gestellt. Dabei handelte es sich in 38 Fällen um benigne, in 15 um borderline und in 13 um maligne Tumore. Lokalrezidive traten bei einem benignen PT, 7 borderline und 5 malignen PT auf. Zwei initiale borderline PT zeigten dabei eine Progression zu malignen PT. Multizentrizität trat in etwa 20 % der borderline und malignen PT aber nur bei 5 % der benignen PT auf.Die Resektionsgrenzen bei Phylloides-Tumoren sollten abhängig von Dignität und Rezidivierung gewählt werden. In Frage zu stellen ist vor allem, ob ein Sicherheitsabstand bei benignen PT einzuhalten ist. Bei einem Auftreten von Rezidiven von borderline oder malignen PT sollte die Indikation zur Mastektomie eher großzügig gestellt werden.

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Local Recurrence of Benign, Borderline, and Malignant Phyllodes Tumors of the Breast: A Systematic Review and Meta-analysis

Cited by 121 publications

References 64 publications

Adjuvant radiotherapy and chemotherapy for patients with breast phyllodes tumors: a systematic review and meta-analysis

Adjuvant radiotherapy and chemotherapy for patients with breast phyllodes tumors: a systematic review and meta-analysis

Recurrent giant phyllodes tumour in a 17-year-old female: a rare case report

Zur Therapie von Phylloides-Tumoren der Brust – eine Aufarbeitung von 66 Fällen mit Literaturübersicht

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