Margin Status and Local Recurrence in Phyllodes Tumours of the Breast: A Canadian Series

Moldoveanu, Dan; Iny, Ericka; Theriault, Chloe; Florea, Anca; Wong, Stéphanie; Basik, Mark; Boileau, Jean-François; Margolese, Richard G.; Pelmus, Manuela; Meterissian, Sarkis; Prakash, Ipshita

doi:10.1245/s10434-022-12894-2

Cited by 3 publications

(4 citation statements)

References 32 publications

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“…In our study, we found that oral contraceptive use for more than 6 months and smoking were also associated with disease recurrence, which has not been mentioned in previous studies. Additionally, we confirmed that larger tumor size, malignant subtype, high mitotic rate, stromal overgrowth, and stromal cell atypia were the risk factors for relapse, which is consistent with the findings of similar studies [ 27 , 38 ]. Our study also revealed that tumors larger than 4 cm had a high risk of recurrence, and achieving a negative margin in this group of patients was significantly associated with a lower risk of recurrence.…”

Section: Discussionsupporting

confidence: 92%

“…NCCN guidelines were modified in 2021 and now recommend surgical excision without obtaining surgical margins for benign PT [ 24 ]. However, the latest published article suggests that having a free margin in the first surgery may be beneficial for reducing the recurrence rates [ 27 ]. This study aimed to identify the risk factors for PT recurrence and the effect of surgical margin on recurrence in patients with identified risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…A meta-analysis by Lu et al reported a recurrence rate of 8% for benign phyllodes tumours [ 31 ], and Tan et al analyzed 440 cases of benign phyllodes tumours and reported a recurrence rate of 10.9% [ 33 ]. However, Moldoveanu et al and Moo et al reported lower recurrence rates of 3.7% and 1.9%, respectively [ 20 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…In many medical centers, the standard practice for the management of close or positive margins in PT is to perform wide local excision and re-excision [ 25 , 26 ]. There is also evidence suggesting that achieving a clear surgical margin during the initial surgery can reduce the risk of tumor recurrence [ 27 ]. This study aims to identify the risk factors for phyllodes tumor recurrence and the effect of a free margin on tumor recurrence by considering these risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Margin status impact on recurrence of phyllodes tumors in high-risk groups: a retrospective observational study

Ranjbar,

Zangouri,

Shokripour

2024

BMC Cancer

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Background Phyllodes tumor (PT) is an fibroepithelial tumor with potential for local recurrence. The optimal margin for surgical resection of PT is still debated, particularly in cases of positive margins. This study aimed to identify the risk factors for phyllodes tumor recurrence and the effect of a free margin on tumor recurrence by considering these risk factors. Materials and methods This is a retrospective observational study of patients diagnosed with PT who had undergone surgical management. The data were collected from medical records from 2001 to 2020 in the breast clinic of Shahid Motahhari Clinic of Shiraz. Patients were followed up for at least 3 years after the operation to be checked for local recurrence or distant metastasis at regular intervals. Results This retrospective study included 319 patients with PT who underwent surgical management. Of these patients, 83.9% (n = 267), 7.6% (n = 24), and 8.5% (n = 27) were classified as benign, borderline, and malignant, respectively. 8.8% of all patients and 7.6% of non-malignant cases experienced local recurrence, and risk factors for recurrence included oral contraceptive use, smoking, size > 4 cm, stromal overgrowth, and stromal cell atypia. A negative surgical margin decreased the prevalence of recurrence in tumors > 4 cm and with stromal overgrowth significantly. Conclusion The study found that a negative margin in all patients did not reduce the recurrence rate in benign and borderline phyllodes tumors, suggesting close follow up as a reasonable alternative. However, a negative margin may be effective in reducing recurrence in certain high-risk groups.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Margin status impact on recurrence of phyllodes tumors in high-risk groups: a retrospective observational study

Ranjbar,

Zangouri,

Shokripour

2024

BMC Cancer

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ASO Author Reflections: Surgical Management of Phyllodes Tumors of the Breast

Iny

Prakash

2022

Ann Surg Oncol

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Postoperative surgical margin results of the phyllodes tumors from a tertiary hospital

Dal,

Havare

2024

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE: Phyllodes tumors in the breast are exceptionally uncommon fibroepithelial tumors. In the literature, they are typically categorized as benign phyllodes tumor, borderline phyllodes tumor, and malignant phyllodes tumor. This study aims to assess and present the clinical and surgical outcomes of patients diagnosed with phyllodes tumor. METHODS: The outcomes of patients aged 18 years and above diagnosed with phyllodes tumor between 2006 and 2023 were retrospectively reviewed. Patients were grouped as benign phyllodes tumor and borderline/malignant phyllodes tumor and compared by clinical and surgical results. RESULTS: Of all 57 patients with phyllodes tumor, 64.9% (n=37) were benign phyllodes tumor and 35.1% (n=20) were borderline/malignant phyllodes tumor [22.8% (n=13) borderline phyllodes tumor and 12.3% (n=7) malignant phyllodes tumor]. When the patients were divided into two groups as benign phyllodes tumor and borderline/malignant phyllodes tumor and compared, our cumulative (total) recurrence rate was 14.0%, with final surgical margin width between groups [(0

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Margin Status and Local Recurrence in Phyllodes Tumours of the Breast: A Canadian Series

Cited by 3 publications

References 32 publications

Margin status impact on recurrence of phyllodes tumors in high-risk groups: a retrospective observational study

Margin status impact on recurrence of phyllodes tumors in high-risk groups: a retrospective observational study

ASO Author Reflections: Surgical Management of Phyllodes Tumors of the Breast

Postoperative surgical margin results of the phyllodes tumors from a tertiary hospital

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