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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2015

01-09-2015 | Breast Oncology

Reappraisal of Conventional Risk Stratification for Local Recurrence Based on Clinical Outcomes in 285 Resected Phyllodes Tumors of the Breast

Authors: Cha Kyong Yom, MD, PhD, Wonshik Han, MD, PhD, Sung-Won Kim, MD, PhD, FACS, So Yeon Park, MD, PhD, In Ae Park, MD, PhD, Dong-Young Noh, MD, PhD

Published in: Annals of Surgical Oncology | Issue 9/2015

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Abstract

Purpose

To ensure a surgical margin of ≥1 cm for the effective treatment of phyllodes tumors of the breast (PTB) a second resection has been recommended, but the outcomes of an extensive series of cases employing the aforementioned criterion cast doubt on this clinical approach. The aim of this study was to identify the local recurrence (LR) risk factors of PTB and determine future optimal surgical treatment according to verified risks.

Methods

All cases given a diagnosis of PTB, and resected between 1989 and 2008, were retrospectively evaluated. Clinicopathologic data and clinical outcomes were analyzed and stratified according to the risks for LR.

Results

All 285 cases were categorized as benign (191, 67.0 %), borderline (61, 21.4 %), or malignant (33, 11.6 %). Median follow-up was 6.7 years and there were 20 LRs during follow-up. All benign PTB recurred as benign PTB lesions. Mitoses (p < 0.001) and tumor size (p = 0.021) were independent prognostic factors for LR in multivariate analysis. Neither margin status (p = 0.758) nor type of surgery (p = 0.922) had any significance for LR. In the risk stratification for LR, PTB ≤5 cm in size with ≥10 mitoses/10 high-power fields (HPFs) had the highest LR rate (55.6 %) compared with all other subgroups (p < 0.001).

Conclusions

It is recommended a wide excision and clear margin of 1 cm be ascertained in only small PTB with frequent mitoses, if necessary by means of a second surgery, which could be considered in order to avoid the risk of LR in this distinct and limited group.
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Metadata
Title
Reappraisal of Conventional Risk Stratification for Local Recurrence Based on Clinical Outcomes in 285 Resected Phyllodes Tumors of the Breast
Authors
Cha Kyong Yom, MD, PhD
Wonshik Han, MD, PhD
Sung-Won Kim, MD, PhD, FACS
So Yeon Park, MD, PhD
In Ae Park, MD, PhD
Dong-Young Noh, MD, PhD
Publication date
01-09-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 9/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4395-5

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