Utilization of Radiotherapy for Malignant Phyllodes Tumors: Analysis of the National Cancer Data Base, 1998–2009

Gnerlich, Jennifer L.; Williams, Rachel; Yao, Kathy; Jaskowiak, Nora; Kulkarni, Swati

doi:10.1245/s10434-013-3395-6

Cited by 114 publications

(77 citation statements)

References 33 publications

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“…This is similar to trends previously reported by Gnerlich et al using the National Cancer Data Base (NCDB). 14 Currently, there are no randomized controlled trials that have examined the efficacy of XRT after margin-negative surgery for phyllodes tumors; however, the relatively high rate of local recurrence (LR) has generated interest in the potential role of XRT. There have been several retrospective studies examining the impact of XRT on local recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…The results of these single institution experiences are mixed however. 1,2,9,10,12,14 A retrospective study by Belkacemi et al evaluated 446 patients treated for phyllodes tumors with a 45% negative margin rate between 1971 and 2003. Adjuvant XRT was administered to 38 (8.5%) patients and they reported a significant decrease in 10 year LR rates from 86% to 56%.…”

Section: Discussionmentioning

confidence: 99%

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Current Trends in the Management of Phyllodes Tumors of the Breast

et al. 2016

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Introduction National Comprehensive Cancer Network (NCCN) guidelines recommend wide excision without axillary staging to treat phyllodes tumors of the breast. Without prospective trials to guide management, NCCN also recommends consideration of radiation therapy (XRT). We describe current patterns of care for the multidisciplinary management of phyllodes tumors. Methods Using Surveillance, Epidemiology and End Results Program (SEER) data, we identified women diagnosed with phyllodes tumors between 2000 and 2012 who underwent surgical therapy. Trends in breast conserving surgery (BCS), nodal sampling and XRT were assessed using the Cochrane-Armitage test. Multivariable logistic regression was used to identify factors associated with treatment. Results Of 1,238 patients, 56.9% underwent BCS and 23.6% underwent nodal sampling (10.5% after BCS vs 40.9% after mastectomy). After surgery, 15.4% received adjuvant XRT (BCS, 12.9% and mastectomy, 18.8%). XRT utilization increased significantly over the study period (BCS, p=<0.0001; mastectomy, p=0.0003) while nodal sampling did not change significantly. Women were more likely to receive mastectomy if they were older or had larger tumors. Nodal sampling was also associated with older age, larger tumor size and receipt of mastectomy. Receipt of XRT was associated with later year of diagnosis, larger tumors and nodal assessment. Conclusion Over time, an increasing number of women received XRT after surgical management of phyllodes tumor, and one in four women underwent nodal sampling. While some of this practice can be attributed to concern about more advanced disease in the absence of strong data, there may be an educational gap regarding current guidelines and appropriate management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Current Trends in the Management of Phyllodes Tumors of the Breast

et al. 2016

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“…However, application of radiotherapy to the breast after surgery for borderline and malignant PTs was shown to reduce the risk of local recurrence, without any significant survival benefit (27,28). Therefore, adjuvant radiotherapy should be considered in patients with borderline and malignant PT on an indidualized basis (4,5).…”

Section: Fnac: Fine Needle Aspiration Cytologymentioning

confidence: 99%

Phyllodes Tumor of the Breast: Analysis of 48 Patients

et al. 2016

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“…Despite a nationwide breast cancer screening program and public awareness activities, it is still not uncommon to see women presenting with large advanced tumours in Singapore [21]. Several authors have found radiation to reduce local recurrence rates, but unlike with the usual invasive breast cancers, radiation did not improve survival in malignant phyllodes [22][23][24].…”

Section: Discussionmentioning

confidence: 99%