Prise en charge des tumeurs phyllodes malignes du sein : l’expérience de l’institut Curie

Haberer, S.; Laé, Marick; Seegers, Valérie; Pierga, Jean‐Yves; Salmon, R; Kirova, Youlia; Dendale, R.; Campana, F.; Reyal, Fabien; Miranda, O.; Bollet, Marc A.

doi:10.1016/j.canrad.2009.05.001

Cited by 25 publications

(19 citation statements)

References 30 publications

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“…; 5‐year NED survival was 82.4% (28/34) in patients who underwent mastectomy and 83.3% (30/36) in patients who had BCS or BCS with adjuvant irradiation). These observations are totally in concordance with the outcomes reported by others, who also showed no significant difference in survival in primary BCS versus patients who underwent mastectomy . Interestingly, identical 5‐year NED survival rates (83.3%) were seen in patients who underwent BCS without irradiation (i.e.…”

Section: Discussionsupporting

confidence: 91%

Malignant Phyllodes Tumor of the Breast: Treatment and Prognosis

et al. 2014

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Surgery remains the mainstay of the treatment in patients with malignant phyllodes tumor of the breast (MPTB); however, the extent of surgery (breast conserving surgery [BCS] versus mastectomy) and the role of adjuvant radiotherapy have been controversial. We report a single institution's experience with MPTB. We discuss controversial therapeutic aspects of this rare tumor. Seventy patients with MPTB treated primarily with surgery were evaluated. The mean age was 50 years (21-76), and the mean size of the tumor was 6 cm. Thirty-four (48.6%) patients were treated with total mastectomy, and 36 (51.4%) were treated with BCS (lumpectomy or wide local excision). Microscopic surgical margins were free of tumor in all cases. In 64 (91.4%) patients, margins were ≥1 cm. Remaining 6 (8.6%) patients treated with BCS margins were <1 cm and subsequently radiotherapy was performed. Among 70 patients, 58 (82.9%) had no evidence of disease (NED) after 5 years. The extent of surgery was not significantly related to the 5-year NED survival rates (82.4% in patients who underwent mastectomy and 83.3% in patients who underwent BCS only or BCS with adjuvant irradiation). The 5-year NED survival rates in BCS (tumor-free margin ≥1 cm) and BCS with irradiation (tumor-free margin <1 cm) groups were identical (83.3%). Our data support the potential use of BCS in patients with MPTB. Mastectomy is indicated only if tumor-free margins cannot be obtained by BCS. Adjuvant radiotherapy may be considered if tumor-free margins are <1 cm.

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Section: Discussionsupporting

confidence: 91%

Malignant Phyllodes Tumor of the Breast: Treatment and Prognosis

et al. 2014

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“…The number of patients treated with BCT increased from 61% to 84.4% (for patients with malignant PT, this change was from 24.7% to 60.0%). It has been unequivocally shown recently that the number of patients treated for PT with BCT significantly increased [1–7,11,12,16–20,25–27]. According to SEER data, about half of the patients with malignant PT have been treated with BCT [28].…”

Section: Discussionmentioning

confidence: 99%

“…Studies performed recently have convincingly shown that excision of a PT with at least 1 cm of free margin (ie, BCT) was the preferred treatment for all patients. Simple mastectomy should be performed only if the tumor diameter/breast size ratio prevents cosmetically satisfactory postoperative appearance of the preserved breast [2–4,7,9,17–20,26]. For all patients, the 5-year NED survival rate increased from 83.2% to 94.5% (it also increased in patients with borderline and malignant PT (Table 3)).…”

Section: Discussionmentioning

confidence: 99%

“…Over the most recent decades, breast-conserving therapy (BCT) has been increasingly offered to patients with PT; the role of adjuvant radiotherapy has also been discussed [1–7,10–12,17–21]. Most investigators have indicated that the treatment efficacy of PT has constantly improved despite reduction of the extent of the surgical excision [2,16,20–23]. …”

Section: Introductionmentioning

confidence: 99%

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Changes in the clinical characteristics, treatment options, and therapy outcomes in patients with phyllodes tumor of the breast during 55 years of experience

et al. 2013

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BackgroundData from the literature suggests that the clinical picture of phyllodes tumor (PT) of the breast, as well as treatment options and perhaps therapy outcomes, have significantly changed. The aim of this work was to review these changes by analysis of consecutive patients with PT over a 55-year period at a single institution.Material/MethodsFrom 1952 to 2007, 280 women with PT were treated surgically at the Maria Skłodowska-Curie Memorial Institute of Oncology, Cancer Center in Cracow. Age, size of breast tumor, microscopic type, extent of surgery, and therapy outcomes were compared between 2 groups: 190 patients treated from 1952 to 1991 vs 90 patients treated from 1992 to 2007.ResultsThe results show that the 1992–2007 group compared to the 1952–1991 included more patients <50 years of age, with tumor <5 cm in diameter, undergoing breast-conserving therapy, as well as no evidence of disease at 5-year survival had increased and this change was statistically significant. In addition, malignant PT cases had decreased in frequency.ConclusionsThe results of this study show that patients with PT are increasingly younger, the breast tumors at diagnosis are smaller, malignant PT is becoming less frequent, and BCT is now the treatment of choice. Most importantly, the general treatment outcomes are significantly better.

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“…[34] Radiotherapy is beneficial as adjuvant modality after surgery in high risk individuals in gaining local control of disease in borderline and malignant phyllodes tumors. [56] Systemic therapy does not appear to have much benefit in phyllodes tumor. [78] Malignant phyllodes can spread to distant sites, most commonly to lungs.…”

Section: Introductionmentioning

confidence: 99%

Aggressive palliative surgery in metastatic phyllodes tumor: Impact on quality of life

Kapali¹,

Singh²,

Deo³

et al. 2010

Indian J Palliat Care

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Metastatic phyllodes tumor has very few treatment options. Phyllodes tumor in metastatic setting has limited role of surgery, radiotherapy and chemotherapy or combined treatment. Most of the patients receive symptomatic management only. We present a case of metastatic phyllodes tumor managed with aggressive margin negative resection of primary tumor leading to palliation of almost all the symptoms, which eventually led to improved quality of life and probably to improved survival. The improved quality of life was objectively assessed with Hamilton depression rating scale. Surgery may be the only mode of palliation in selected patients that provides a better quality of life and directly or indirectly may lead to improved survival.

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Prise en charge des tumeurs phyllodes malignes du sein : l’expérience de l’institut Curie

Cited by 25 publications

References 30 publications

Malignant Phyllodes Tumor of the Breast: Treatment and Prognosis

Malignant Phyllodes Tumor of the Breast: Treatment and Prognosis

Changes in the clinical characteristics, treatment options, and therapy outcomes in patients with phyllodes tumor of the breast during 55 years of experience

Aggressive palliative surgery in metastatic phyllodes tumor: Impact on quality of life

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