Open AccessHow Wide Should Margins Be for Phyllodes Tumors of the Breast?
Author(s) -
TremblayLeMay Rosemarie,
Hogue JeanCharles,
Provencher Louise,
Poirier Brigitte,
Poirier Éric,
Laberge Sophie,
Diorio Caroline,
Desbiens Christine
Publication year - 2016
Publication title -
the breast journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.533
H-Index - 72
eISSN - 1524-4741
pISSN - 1075-122X
DOI - 10.1111/tbj.12727
Subject(s) - medicine , biopsy , distant metastasis , phyllodes tumor , surgery , breast cancer , retrospective cohort study , radiology , wide local excision , cancer , metastasis , general surgery
Abstract The surgical management of phyllodes tumors ( PT s) is still controversial. Some studies have suggested surgical margins ≥1 cm, but recent studies suggested that negative margins could be appropriate regardless of their width. To evaluate recurrence rates of PT s following surgery according to margins. Retrospective study of women who attended a tertiary breast cancer reference center between 1998 and 2010: 142 patients with a PT diagnosis, either at minimally invasive breast biopsy or at surgery, were identified. Clinical, pathologic and follow‐up characteristics were assessed. Among 140 patients who underwent surgery, 64.3% of biopsies accurately predicted the final PT diagnosis at surgery. Forty‐two (42/87, 48.3%) PT s had positive margins. Twenty‐one (21/42, 50.0%) patients had a surgical revision of margins. Only one (1/42, 2.4%) had margins greater or equal to 1 cm. After a median follow‐up of 1.29 years in benign PT s, 4.99 years in borderline PT s, and 5.42 years in malignant PT s, there were five local recurrences, three in originally benign PT s and two in borderline PT s. All were managed with surgery. Four had initial margins ≤1 mm. One patient with borderline PT had a local recurrence and later progressed to regional recurrence and metastasis. Free surgical margins are necessary to treat PT , and margins of at least 1 mm might be sufficient to prevent recurrence. Core needle biopsy might not be the best diagnostic tool for PT s.