Phyllodes tumours of the breast: Outcomes and recurrence after excision

Wen, Betty; Mousadoust, Dorsa; Warburton, Rebecca; Pao, Jin-Si; Dingee, Carol; Chen, Leo; McKevitt, Elaine

doi:10.1016/j.amjsurg.2020.02.048

Cited by 17 publications

(10 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The extent of resection in terms of lumpectomy vs mastectomy was not predictive of recurrence, similar to the results of Wen et al in their analysis of 96 patients at a single center. 10 In our study, mastectomy was more frequently performed in patients with malignant PT.…”

Section: Discussionmentioning

confidence: 67%

Clinicopathologic Characteristics and Patient Outcomes of Phyllodes Tumors: A Single Institution Experience

Mohan

Tseng

Angarita

et al. 2021

The American Surgeon

View full text Add to dashboard Cite

Phyllodes tumors (PT) are rare fibroepithelial neoplasms that are classified as benign, borderline, or malignant. Patients with PT diagnosed between 2009 and 2019 were identified from a prospectively maintained single institutional database. 76 patients with PT were included; 47 (61.8%) were benign, 9 (11.8%) were borderline, and 20 (26.3%) were malignant. The mean age at diagnosis was 52. Surgical treatment of benign PT included excisional biopsy in 31 (66.0%) patients, segmental mastectomy in 15 (31.9%), and mastectomy in 1 (2.1%). Among patients with borderline PT, operative management was excisional biopsy in 4 (44.4%) and segmental mastectomy in 5 (55.6%). Of those with malignant PT, 7 (35.0%) were treated with excisional biopsy alone, 9 (45.0%) had lumpectomy (segmental mastectomy), and 4 (20.0%) underwent mastectomy. Malignant PT had a higher rate of necrosis compared to borderline or benign PT (25.0% vs 0% vs 4.3%, P = .016). Four patients had recurrent PT. Final positive margins were associated with recurrence ( P = .044). The median overall follow-up time was 86.3 months (range 1.5-1414.1 months), and no deaths occurred among patients with malignant PT. Overall, recurrence rates of PT are low but may be increased by presence of positive margins.

show abstract

Section: Discussionmentioning

confidence: 67%

Clinicopathologic Characteristics and Patient Outcomes of Phyllodes Tumors: A Single Institution Experience

Mohan

Tseng

Angarita

et al. 2021

The American Surgeon

View full text Add to dashboard Cite

show abstract

“…On the other hand, borderline PT have higher risk of local recurrence and can undergo metastasis, although rarely. Malignant phyllodes, on an extreme end of the spectrum, have local recurrence in 23%–30% cases and a highest risk of metastasis, which usually develops within 10 years of the diagnosis 22–24 …”

Section: Discussionmentioning

confidence: 99%

“…Malignant phyllodes, on an extreme end of the spectrum, have local recurrence in 23%-30% cases and a highest risk of metastasis, which usually develops within 10 years of the diagnosis. [22][23][24] Differentiating conventional fibroadenoma from PT has never been any issue, however the main diagnostic dilemma lies while dealing with cellular/juvenile FA and PT (especially benign and borderline), as both of them can show overlapping radiological and cytological Note: Bold denotes p value <0.05 mean significant features. 25,26 Many a times the smears of cellular FA show mirroring features with the PT, like they are two peas in a pod, further making it an 'instinct' call for the cytologist as to where to fit; which many a times leads to signing out as a differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Cellular fibroadenoma versus phyllodes tumors: A pre‐operative diagnostic approach based on radiological and cytological features

Rana

Kamal

Mishra

et al. 2022

Diagnostic Cytopathology

View full text Add to dashboard Cite

Objective This study has been designed in an effort to identify the clinico‐radiological and cytological features that could effectively help in differentiating cellular fibroadenoma (CFA) and phyllodes tumors (PT), which have several overlapping characteristics. Method Histologically proven cases of CFA and PT were reviewed. Cytological features were assessed and categorized. Clinical and radiological details were also evaluated and he the two groups were compared statistically. Results A total of 43 FA and 52 PT were specimens were reviewed. Mean age and tumor size for CFA and PT were 26.05 and 36.94 years, and 3.7 and 6.4 cm, respectively. Univariate analysis and regression models revealed that age >30 years, BIRADS grade of 4 or more, marked cellularity of stromal fragments, more than 30% spindle cells in background cell population and presence of traversing blood vessels in stromal fragments increased the odds of a tumor being phyllodes. The binary logistic regression model was able to predict PT accurately in 87.2% cases (p < .001). Conclusion PT and CFA could be differentiated if cytological findings are cautiously correlated clinically and radiologically. Age, BIRADS category along with assessment of stromal fragments and background population can effectively distinguish between CFA and PT.

show abstract

“…3,4 Local recurrence of PTs has a reported incidence of between 7.3% and 17%. 4,5,6 There has been debate about the margins of excision and the value of reexcisions for non-malignant lesions. 7 Increasingly, a negative margin is considered sufficient and margin width is not predictive of local recurrence.…”

Section: Introductionmentioning

confidence: 99%

“…7 Increasingly, a negative margin is considered sufficient and margin width is not predictive of local recurrence. 2,5,7,8 A tumour-free excision margin may reduce local recurrence; 9 however, the significance of clear margins or re-excision remains uncertain. 10 There is great variation in patients' surveillance protocols following the excision of PTs.…”

Section: Introductionmentioning

confidence: 99%

Benign and Borderline Phyllodes: Management and Follow-Up

2022

View full text Add to dashboard Cite

Background: Phyllodes tumours of the breast are benign, borderline or malignant fibroepithelial lesions. They are uncommon and usually treated with surgical or radiological excision. The association with local recurrence has led to much debate over the extent of excision margins. It has traditionally followed that clinical surveillance for local recurrence is necessary following surgery. Follow-up is without any nationally agreed protocol and is therefore variable. Methods: After exclusions, 116 cases of benign (n=81), borderline (n=30) and malignant (n=5) phyllodes tumours were identified in a single centre, between 2005 and 2018. These were analysed using a database, electronic patient records and notes-based review. Results: Benign recurrence occurred in six patients with complete excision of benign PTs (7.4%) and one with borderline PT (3.3%). No malignant Phyllodes tumours developed following excision of benign or borderline lesions. Conclusions: This study of 13 years experience with 111 non-malignant Phyllodes tumours provides support for no routine clinical surveillance, but it supports patient education and open access to breast clinic.

show abstract

Phyllodes tumours of the breast: Outcomes and recurrence after excision

Cited by 17 publications

References 19 publications

Clinicopathologic Characteristics and Patient Outcomes of Phyllodes Tumors: A Single Institution Experience

Clinicopathologic Characteristics and Patient Outcomes of Phyllodes Tumors: A Single Institution Experience

Cellular fibroadenoma versus phyllodes tumors: A pre‐operative diagnostic approach based on radiological and cytological features

Benign and Borderline Phyllodes: Management and Follow-Up

Contact Info

Product

Resources

About