Surgery for phyllodes tumour of the breast. What should be surgical margins?

Abstract

Backgrounds Optimal and tailored surgical treatment of phyllodes tumour(PT) of the breast is controversial. This study aims to determine the appropriate surgical margin in the treatment of PT. Methodology The data of 132 patients who underwent breast surgery with the diagnosis of PT at the Breast Unit of Istanbul Faculty of Medicine from 2000 to 2022 were retrospectively reviewed. Results Median age was 38 and patients with benign PT were younger than others(median age was 34, 44, and 43 for benign, borderline, and malignant, respectively) (P = 0.001). Local recurrence was observed in 7 (5.3%) patients, systemic recurrence was observed in 3 (2.3%) patients, and disease‐related death was observed in 2 (1.5%) patients. Local recurrence occurred in 1.4% (n = 1) of benign tumours, 8.3% (n = 2) of borderline tumours, and 10.3% (n = 4) of malignant tumours. All of the systemic recurrences and deaths were seen in the malignant group. The local recurrence rate was found to be higher in borderline and malignant tumours with surgical margins less than 10 mm (44.4% versus 3.7%, P = 0.003), and tumours larger than 5 cm (11.8% versus 1.3%, P = 0.015). In comparison, there was no correlation between the surgical margin proximity, tumour diameter, and local recurrence rates in benign PT (P > 0.05). Conclusion According to our findings, negative surgical margins seem to be sufficient in the treatment of benign phyllodes tumours. Furthermore at least 1 cm negative surgical margins must be achieved for malignant and borderline phyllodes tumours to avoid local recurrence.

Avaliação de margens cirúrgicas e prevalência de neoplasias mamárias em cadelas: um estudo retrospectivo

“…Em cães os estudos sobre margens cirúrgicas em neoplasias mamárias são escassos, Guim et al (2013) observaram que, entre os subtipos, os carcinomas sólidos e anaplásicos apresentaram maior comprometimento de margens, assim como tumores maiores que 5 cm, corroborando com o presente estudo. Em mulheres com câncer de mama o objetivo da cirurgia conservadora é a obtenção de margens livres, ela é considerada adequada com 10mm, e as pacientes que apresentaram comprometimento de margens tiveram maior chance de apresentar recorrência local (Silva et al, 2014;Tukenmez et al, 2023).…”

“…Desta forma a avaliação das margens cirúrgicas é essencial para informar a eficácia do procedimento cirúrgico realizado e se há necessidade da realização de terapias complementares (Guim et al, 2013). Em mulheres com neoplasia mamária, a margem cirúrgica comprometida é relatada como um fator de maior chance de recorrência tumoral, e é um importante fator de prognóstico, estando relacionado ao risco da ocorrência de metástase à distância (Silva et al, 2014;Priddy et.al, 2016;Tukenmez et al, 2023).…”