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28-08-2023 | Breast Oncology

Management of Benign Phyllodes Tumors: A Dutch Population-Based Retrospective Cohort Between 1989 and 2022

Authors: Josefien P. van Olmen, MD, Annemijn W. J. Beerthuizen, MD, Elise M. Bekers, MD, Isabella Viegen, MSc, Caroline A. Drukker, MD, PhD, Marie-Jeanne T. F. D. Vrancken Peeters, MD, PhD, Sanne A. L. Bartels, MD, PhD, Frederieke H. van Duijnhoven, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2023

Abstract

Background

Phyllodes tumors (PTs) are rare tumors of the breast. The current National Comprehensive Cancer Network (NCCN) guidelines recommend excision of benign PTs, accepting close or positive margins. Controversy about the optimal treatment for benign PTs remains, especially regarding the preferred margin width after surgical excision and the need for follow-up evaluation.

Methods

A nationwide retrospective study analyzed the Dutch population from 1989 to 2022. All patients with a diagnosis of benign PT were identified through a search in the Dutch nationwide pathology databank (Palga). Information on age, year of diagnosis, size of the primary tumor, surgical treatment, surgical margin status, and local recurrence was collected.

Results

The study enrolled 1908 patients with benign PT. The median age at diagnosis was 43 years (interquartile range [IQR], 34–52 years), and the median tumor size was 30 mm (IQR, 19–40 mm). Most of the patients (95%) were treated with breast-conserving surgery (BCS). The overall local recurrence rate was 6.2%, and the median time to local recurrence was 31 months (IQR, 15–61 months). Local recurrence was associated with bilaterality of the tumor (odds ratio [OR], 4.91; 95% confidence interval [CI], 2.95–28.30) and positive margin status (OR, 2.51; 95% CI 1.36–4.63). The local recurrence rate was 8.9% for the patients with positive excision margins and 4.0% for the patients with negative excision margins. Notably, for 27 patients (22.6%) who experienced a local recurrence, histologic upgrading of the recurrent tumor was reported, 7 (5.9%) of whom had recurrence as malignant lesions.

Conclusions

This nationwide series of 1908 patients showed a low local recurrence rate of 6.2% for benign PT, with higher recurrence rates following positive margins.

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Title: Management of Benign Phyllodes Tumors: A Dutch Population-Based Retrospective Cohort Between 1989 and 2022
Authors: Josefien P. van Olmen, MD
Annemijn W. J. Beerthuizen, MD
Elise M. Bekers, MD
Isabella Viegen, MSc
Caroline A. Drukker, MD, PhD
Marie-Jeanne T. F. D. Vrancken Peeters, MD, PhD
Sanne A. L. Bartels, MD, PhD
Frederieke H. van Duijnhoven, MD, PhD
Publication date: 28-08-2023
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 13/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-023-14128-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Management of Benign Phyllodes Tumors: A Dutch Population-Based Retrospective Cohort Between 1989 and 2022

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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