Phyllodes tumours of the breast: Outcomes and recurrence after excision

Betty Wen; Dorsa Mousadoust; Rebecca Warburton; Jin-Si Pao; Carol Dingee; Leo Chen; Elaine McKevitt

doi:10.1016/j.amjsurg.2020.02.048

Phyllodes tumours of the breast: Outcomes and recurrence after excision

Am J Surg. 2020 May;219(5):790-794. doi: 10.1016/j.amjsurg.2020.02.048. Epub 2020 Feb 28.

Authors

Betty Wen¹, Dorsa Mousadoust², Rebecca Warburton³, Jin-Si Pao⁴, Carol Dingee⁵, Leo Chen⁶, Elaine McKevitt⁷

Affiliations

¹ Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada; Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: betty.wen@alumni.ubc.ca.
² Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada; Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: dorsamousadoust@alumni.ubc.ca.
³ Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada; Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: RWarburton@providencehealth.bc.ca.
⁴ Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada; Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: JPao@providencehealth.bc.ca.
⁵ Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada; Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: Ckdingee@telus.net.
⁶ Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: leochen1@mail.ubc.ca.
⁷ Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada; Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: emckevitt@providencehealth.bc.ca.

PMID: 32145921
DOI: 10.1016/j.amjsurg.2020.02.048

Abstract

Introduction: Wide excision margins are traditionally recommended for phyllodes tumours of the breast to reduce recurrence. Recent studies suggest margin status and histopathological features, excluding margin width, influence recurrence. This study evaluated treatment outcomes for phyllodes tumours and examined predictors of recurrence.

Methods: Clinical and follow-up information for phyllodes tumours patients treated between 2008 and 2017 were obtained from chart review. Tumour subtype and histopathological features were determined from pathology reports. Primary endpoints were recurrence rate and time to recurrence or mortality.

Results: Among 96 patients, there were 6 local and 1 distant recurrences. Overall recurrence rate was 7.3% and average time-to-recurrence was 13.7 months. Tumour size, margin status, necrosis, and mitoses were associated with recurrence; margin width was not. Two deaths (2.1%) from malignant phyllodes occurred.

Conclusions: Multiple histopathological features influence phyllodes recurrence. Wide excision and re-excising positive margins for benign tumours was not beneficial.

Keywords: Breast tumor; Excision; Fibroepithelial; Phyllodes; Recurrence.

MeSH terms

Adult
Breast Neoplasms / pathology
Breast Neoplasms / surgery*
Female
Humans
Margins of Excision
Middle Aged
Neoplasm Recurrence, Local / pathology*
Phyllodes Tumor / pathology
Phyllodes Tumor / surgery*
Risk Factors
Time Factors