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Phyllodes tumour among participants in screening mammography
Author(s) -
Farshid Gelareh,
Gill P. Grantley
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13056
Subject(s) - medicine , fibroadenoma , incidence (geometry) , mammography , screening mammography , retrospective cohort study , breast cancer screening , biopsy , cancer , cohort , phyllodes tumor , breast cancer , radiology , physics , optics
Abstract Background In screening, the distinction between phyllodes tumour ( PT ) and fibroadenoma ( FA ) is imprecise, often needing surgery. Methods In this retrospective cohort study and literature review, we wished to (i) present our experience with PT diagnosed among screening participants; (ii) identify discriminating features between FA and PT ; (iii) assess the efficacy of cancer screening in identifying PT ; and (iv) for women diagnosed with PT , determine appropriate breast cancer screening schedules. Results During a 23.7 years time frame, PT was diagnosed in 30 women, reflecting an incidence of 2.53 per 100 000 women screened. Only 22 (73.3%) PT were found by screening. The remaining eight (26.7%) presented as interval tumours. Thirteen PT were benign, eight borderline and nine malignant. Six of eight (75%) malignant PT were symptomatic. A circumscribed mass, mean diameter 34.7 mm, was the dominant finding. Enlargement (14 imaging, seven clinical) was documented in 21 (70%) cases. Diagnostic open biopsy was required in 67.9%. Follow‐up of at least 12 months is available in 20 cases. Only two developed recurrence. One woman died of metastatic PT and one PT recurred locally. Conclusion The extreme rarity of PT in screening contrasts with the prevalence of FAs . The peak incidence of PT in women is 40–50, whereas screening is targeted at women 50–74. Two yearly screening mammography is not designed to detect PT reliably. In particular, malignant PT grows rapidly and becomes symptomatic. Women with benign PT can continue with screening. Women with borderline and malignant PT should resume screening after 5 years of specialist surveillance.