Document Detail


Phyllodes tumor of the breast.
MedLine Citation:
PMID:  17931796     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To better identify prognostic factors for local control and survival, as well as the role of different therapeutic options, for phyllodes tumors, a rare fibroepithelial neoplasm of the breast. METHODS AND MATERIALS: Data from 443 women treated between 1971 and 2003 were collected from the Rare Cancer Network. The median age was 40 years (range, 12-87 years). Tumors were benign in 284 cases (64%), borderline in 80 cases (18%), and malignant in 79 cases (18%). Surgery consisted of breast-conserving surgery (BCS) in 377 cases (85%) and total mastectomy (TM) in 66 cases (15%). Thirty-nine patients (9%) received adjuvant radiotherapy (RT). RESULTS: After a median follow-up of 106 months, local recurrence (LR) and distant metastases rates were 19% and 3.4%, respectively. In the malignant and borderline group (n = 159), RT significantly decreased LR (p = 0.02), and TM had better results than BCS (p = 0.0019). Multivariate analysis revealed benign histology, negative margins, and no residual disease (no RD) after initial treatment and RT delivery as independent favorable prognostic factors for local control; benign histology and low number of mitosis for disease-free survival; and pathologic tumor size < or = 3 cm and no tumor necrosis for overall survival. In the malignant and borderline subgroup multivariate analysis TM was the only favorable independent prognostic factor for disease-free survival. CONCLUSIONS: This study showed that phyllodes tumor patients with no RD after treatment have better local control. Benign tumors have a good prognosis after surgery alone. In borderline and malignant tumors, TM had better results than BCS. Thus, in these forms adjuvant RT should be considered according to histologic criteria.
Authors:
Yazid Belkacémi; Guilhem Bousquet; Hugo Marsiglia; Isabelle Ray-Coquard; Nicolas Magné; Yann Malard; Magalie Lacroix; Cristina Gutierrez; Elzbieta Senkus; David Christie; Karen Drumea; Edouard Lagneau; Sidney P Kadish; Luciano Scandolaro; David Azria; Mahmut Ozsahin
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2007-10-10
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  70     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-21     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  492-500     Citation Subset:  IM    
Affiliation:
Centre Oscar Lambret, Lille, France. y-belkacemi@o-lambret.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Analysis of Variance
Breast Neoplasms / pathology,  radiotherapy,  surgery*
Child
Female
Follow-Up Studies
Humans
Mastectomy
Mastectomy, Segmental
Middle Aged
Neoplasm Recurrence, Local
Phyllodes Tumor / pathology,  radiotherapy,  secondary,  surgery*
Prognosis
Radiotherapy, Adjuvant
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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