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

Lohmeyer, Jörn Andreas; Huster, Nora; Lühr, C; Lindner, Christoph; Wittig, Klaus; Keck, Maike

doi:10.1055/a-1164-6791

Cited by 3 publications

(10 citation statements)

References 24 publications

(35 reference statements)

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“…En una revisión sistemática y metanálisis que tuvo como objetivo investigar las tasas de recurrencia local (LR) entre los tres tipos de tumores filoides, se obtuvo los siguientes resultados: La revisión incorporó 54 estudios con 9234 casos individuales. Las tasas de recurrencia fueron del 8 % para los filoides benignos, del 13 % para los limítrofes y del 18 % para los malignos (29).…”

Section: Resultsunclassified

Tumor filoides de mama. Reporte de caso clinico y revisión de la literatura

et al. 2022

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Introducción: El tumor filoide de mama, es una neoplasia fibroepitelial rara, de crecimiento rápido, que representa del 0,3% al 1% de todos los tumores de mama. Se clasifican de acuerdo a su histopatología en, benignos, lo cual representa su gran mayoría, malignos y limítrofes. Clínicamente tienen un crecimiento rápido, son indoloros, recidivantes y deforman extraordinariamente la mama. La importancia en el diagnóstico precoz radica en evitar el desarrollo de complicaciones mayores o que se permita el progreso de una neoplasia cuando se trata de un tumor filoides maligno. El tratamiento va a depender del tipo histológico del tumor y el seguimiento se considera un proceso fundamental. Objetivo: Describir un caso clínico de Tumor filoides de mama y revisión bibliográfica de su presentación clínica, tipos histológicos, diagnóstico y tratamiento. Materiales y Métodos:Se realiza revisión exhaustiva de artículos científicos, consultando las bases de datos PUBMED, ELSEVIER, EPISTEMONIKOS, MedLine, The Cochranre Library Plus, seleccionándose artículos en su mayoría del año 2017 en adelante, en los idiomas español e inglés. Se revisaron artículos completos y resúmenes sobre el tema.Resultados: Se seleccionaron 30 artículos. Artículos de revisión, meta-análisis, estudios observacionales, descriptivos, retrospectivos, opiniones de autores y normas de la Red Nacional Integral del Cáncer. Se realizó un Estudio descriptivo, retrospectivo, para presentación de caso clínico correspondiente a Tumor filoides. Se presenta el caso clínico de paciente de sexo femenino de 27 años de edad que manifiesta una tumoración en mama derecha de gran tamaño, indolora, que produce deformidad, de dos meses de evolución, cuya histopatología corresponde a un tumor filoides benigno y que recibe tratamiento quirúrgico realizándose cirugía conservadora de la mama. Conclusiones: El tumor filoide es una neoplasia fibroepitelial infrecuente, clínicamente se puede confundir con un fibroadenoma, debe ser diagnosticado a tiempo mediante histopatología, debe determinarse el subtipo de tumor, ya que puede ser benigno, maligno o limítrofe y su tratamiento va a depender de su patrón histopatológico, pudiendo realizarse cirugía conservadora de la mama, mastectomía y en casos de tumores malignos infiltrantes y metastásicos se puede complementar con radioterapia y quimioterapia adyuvante

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Section: Resultsunclassified

Tumor filoides de mama. Reporte de caso clinico y revisión de la literatura

et al. 2022

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“…Although several studies have shown that additional radiation therapy of malignant PTs is associated with nearly halving the local recurrence rate. 18 For borderline and malignant tumors an analysis of cases collected from the Rare Cancer Network between 1971 and 2003 showed that adjuvant radiotherapy yielded superior 10-year local control rates (86% with radiation versus 59% without radiation), but no survival benefit [20]. The NCCN guidelines (Version 1.2021) recommend adjuvant radiotherapy after primary resection only if additional recurrence would create significant morbidity, such as a chest wall recurrence following mastectomy.…”

Section: Discussionmentioning

confidence: 99%

“…34,35 Metastasis is predominantly hematogenous to the lungs, bones, and viscera. 18,23 For phyllodes tumors, recurrence rates within the first 2-3 years of 10%-17%, 14%-25%, and 23%-30% are reported for benign, borderline and malignant tumors respectively. 17 The mean time to recurrence of benign, borderline, and malign PT's are reported as 20.2 ± 12.1, 16.9 ± 10.8, and 20.3 ± 19.0 months, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical lymphadenopathy is noted in 10%–15% of patients presenting with malignant PTs but is usually either related to tumor necrosis or to infected ulcerated skin lesions, with <1% pathological involvement 34,35 . Metastasis is predominantly hematogenous to the lungs, bones, and viscera 18,23 …”

Section: Discussionmentioning

confidence: 99%

“…The US American National Comprehensive Cancer Network (NCCN) recommends a resection distance of at least 1 cm regardless of the dignity of the tumor; the AGO (Gynecological Oncology Working Group) states that 0.5 cm is sufficient for borderline and malignant PTs. 18 In this article, the diversity in morphological appearances of PTs, their course and therapeutic concepts, including breast reconstruction are explored and discussed within the context of the current state of the literature.…”

Section: Introductionmentioning

confidence: 99%

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The phyllodes menace—Variation in course, therapy, and appearance of phyllodes tumors in a case series of three patients

Schiltz,

Sokolow,

Minck

et al. 2023

Clinical Case Reports

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Key Clinical MessageEarly and complete surgical resection is the most important therapeutic and diagnostic measure. Adjuvant radiation is suggested for malign phyllode tumors, phyllode tumors larger than 10 cm or those with a low distance to the resection margins.AbstractPhyllodes tumors are rare fibroepithelial tumors of the breast. Histologically, they are usually classified as benign, borderline or malignant, though these classifications do not necessarily reflect the clinical course of the disease. These tumors may stay undetected for years, or show sudden and rapid progression. There is currently no consistent therapy recommendation based upon histological findings, the localization of the tumor and/or whether it is recurrent. Using the examples of three patients, we show how courses and therapy may differ widely, and discuss this in the context of the current state of the literature.

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Nipple-sparing mastectomy and immediate breast reconstruction by prepectoral implant for the management of giant phyllodes tumors: A case series

Abdelwahab,

Elsaeed,

Hamdy

et al. 2024

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Phyllodes tumor is an uncommon breast neoplasm that is present in variable sizes. Giant phyllodes are those larger than 10 cm in diameter. Clinically, giant phyllodes tumors present as a visible, rapidly growing mass distorting the breast contour. Such tumors with large size and rapid growth rate suggest a phyllode diagnosis of fibroadenoma. Planning a standard treatment strategy for these tumors is quite challenging. While adequate surgical excision with tumor-free resection margins is the standard of care for most giant phyllodes cases, borderline and malignant giant phyllodes tumors might require wider resections given their high recurrence rates. Some authors described total mastectomy as the treatment option for giant borderline and malignant phyllodes to obtain wide, clear margins. Between March 2022 and September 2023, our surgical oncology department presented and operated on three cases of giant phyllodes. They underwent a nipple-sparing mastectomy and immediate breast reconstruction using pre-pectoral silicone implants. We think that with such a procedure, we can benefit from the wide, safe margins of mastectomy that have been proven to decrease local recurrence rates while considering the aesthetic outcome.

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

Cited by 3 publications

References 24 publications

Tumor filoides de mama. Reporte de caso clinico y revisión de la literatura

Tumor filoides de mama. Reporte de caso clinico y revisión de la literatura

The phyllodes menace—Variation in course, therapy, and appearance of phyllodes tumors in a case series of three patients

Nipple-sparing mastectomy and immediate breast reconstruction by prepectoral implant for the management of giant phyllodes tumors: A case series

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