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Malignant phyllodes tumor of the female breast
Author(s) -
Macdonald O. Kenneth,
Lee Christopher M.,
Tward Jonathan D.,
Chappel Craig D.,
Gaffney David K.
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22228
Subject(s) - medicine , lumpectomy , mastectomy , breast cancer , oncology , univariate analysis , radiation therapy , multivariate analysis , proportional hazards model , population , surgery , cancer , gynecology , environmental health
BACKGROUND. Malignant phyllodes tumor is a rare and potentially aggressive breast neoplasm. Little information is available regarding the optimal management of these lesions and rarer still are data regarding survival. The current study used a large population database to determine prognostic factors that predict cause‐specific survival (CSS). METHODS. Data were obtained from the Surveillance, Epidemiology, and End Results Program (SEER) for the years 1983–2002. Women receiving resection for primary nonmetastatic malignant phyllodes tumor of the breast were included ( n = 821). Analyses of patient, pathologic, and treatment characteristics were performed using univariate and multivariate Cox regression analyses for the CSS endpoint. RESULTS. With a median follow‐up of 5.7 years, CSS was 91%, 89%, and 89%, at 5, 10, and 15 years, respectively. Mastectomy was performed in 428 women (52%) and wide excision or lumpectomy in 393 (48%). Women undergoing mastectomy were significantly older ( P = .004) and had larger tumors ( P = .009). Wide excision was associated with equivalent or improved CSS relative to mastectomy on univariate and multivariate analyses. Older age predicted for cause‐specific mortality on multivariate analysis. Adjuvant radiotherapy (RT) predicted for worse CSS when implemented compared with surgery alone. CONCLUSIONS. Mastectomy was not found to provide a benefit in CSS compared with wide excision in malignant phyllodes tumor of the breast. Women undergoing wide excision had at the minimum similar cancer‐specific mortality compared with those who received mastectomy. The role of adjuvant RT is uncertain and requires further investigation. Cancer 2006. © 2006 American Cancer Society.