DOI QR코드

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Comparison of Clinical Characteristics Between Benign Borderline and Malignant Phyllodes Tumors of the Breast

  • Wang, Hui (Department of Breast Surgery, Cancer Institute&Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College) ;
  • Wang, Xiang (Department of Breast Surgery, Cancer Institute&Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College) ;
  • Wang, Cheng-Feng (Department of Breast Surgery, Cancer Institute&Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College)
  • 발행 : 2015.01.22

초록

Background: Phyllodes tumors of the breast are rare fibroepithelial lesions, so relatively little is known about this disease entity. The present study was designed to identify differences in clinical features between benign borderline and malignant phyllodes tumors. Materials and Methods: Data from 246 women with phyllodes tumors of the breast treated in Cancer Hospital Chinese Academy of Medical Sciences between 2002 and 2012 were collected and analyzed, including age at presentation, age at treatment, course, size of primary tumor, location, histological type, type of surgery and treatment, local recurrence, distant metastasis, fibroadenoma history, disease-free survival and number of mitosis per 10hpf. There are 125 (55%) benign, 55 (24%) borderline and 47 (21%) malignant tumors. Results: In univariate analysis, average age at presentation, average age at treatment, size of primary tumor, ulceration or not, type of primary surgery, distant metastasis and number of mitosis per 10 hpf turned out to be statistically different among the three PT types (p=0.014, 0.018, <0.000, 0.003, <0.000, 0.001 and <0.000, respectively), while recurrence and disease-free survival (DFS) demonstrated trends for statistical significance (P =0.055 and 0.060, respectively). Multivariate analysis revealed distant metastasis and excision were significantly different in benign, borderline and malignant phyllodes tumors of the breast (p=0.041 and 0.018, OR=0.061 and 0.051). At the same time, size of primary tumor with p=0.052 tended to be different between groups (OR=1.127). However, age at treatment, ulceration and DFS showed no statistically significant variation (p=0.400, 0.286 and 0.413, respectively). Conclusions: Benign borderline and malignant phyllode tumors have different distant metastasis risk, different primary tumor size and different surgical procedures, and malignant PTs are more likely to be bigger and to metastasize.

참고문헌

  1. August DA, Kearney T (2000). Cystosarcoma phyllodes: mastectomy, lumpectomy, or lumpectomy plus irradiation. Surg Oncol, 9, 49-52. https://doi.org/10.1016/S0960-7404(00)00022-0
  2. Barrio AV, Clark BD, Goldberg JI, et al (2007). Clinicopathologic features and long-term outcomes of 293 phyllodes tumors of the breast. Ann Surg Oncol, 14, 2961-70. https://doi.org/10.1245/s10434-007-9439-z
  3. Belkacemi Y, Bousquet G, Marsiglia H, et al (2008). Phyllodes tumor of the breast. Int J Radiat Oncol Biol Phys, 70, 492-500. https://doi.org/10.1016/j.ijrobp.2007.06.059
  4. Chaney AW (2000). Primary treatment of cystosarcoma phyllodes of the breast. Cancer, 89, 1502-10. https://doi.org/10.1002/1097-0142(20001001)89:7<1502::AID-CNCR13>3.0.CO;2-P
  5. Hassouna JB, Damak T, Gamoudi A, et al (2006). Phyllodes tumors of the breast: a case series of 106 patients. Am J Surg, 192, 141-7. https://doi.org/10.1016/j.amjsurg.2006.04.007
  6. Karim RZ, Gerega SK, Yang YH, et al (2009). Phyllodes tumours of the breast: a clinicopathological analysis of 65 cases from a single institution. Breast, 18, 165-70. https://doi.org/10.1016/j.breast.2009.03.001
  7. Khurshid A, Kayani N, Bhurgri Y (2006). Phylloides tumors in adolescent girls and young women in Pakistan. Asian Pac J Cancer Prev, 7, 563-6.
  8. Lee B, Pack G (1931). Giant intracanalicular fibroadenomyxoma of the breast. Am J Cancer, 15, 2583.
  9. Muller J (1838). Ueber den Feinen Bau Und die Furmen Der Krankhaften Geschwulste. Berlin: G. Reimer.
  10. NCCN Clinical Practice Guidelines in Oncology (2014 NCCN Guidelines), Breast Cancer, Version 1.2014, MS56. Available at: http://www.nccn.org.
  11. Reinfuss M, Mitus J, Duda K, et al (1996). The treatment and prognosis of patients with phyllodes tumor of the breast: An analysis of 170 cases. Cancer, 77, 910-6. https://doi.org/10.1002/(SICI)1097-0142(19960301)77:5<910::AID-CNCR16>3.0.CO;2-6
  12. Rowell MD, Perry RR, Hsiu JG, et al (1993). Phyllodes Tumors. Am J Surg, 165, 376-9. https://doi.org/10.1016/S0002-9610(05)80849-9
  13. Suzuki-Uematsu S, Shiraishi K, Ito T, et al (2010). Malignant phyllodes tumor composed almost exclusively of a fibrosarcomatous component: a case report and review of malignant phyllodes tumors with metastases. Breast Cancer, 17, 218-24. https://doi.org/10.1007/s12282-009-0099-7
  14. Taira N, Takabatake D, Aogi K, et al (2007). Phyllodes tumor of the breast:stromal overgrowth and histological classification are useful prognosis predictive factors for local recurrence in patients with a positive surgical margin. Jpn J Clin Oncol, 37, 730-6. https://doi.org/10.1093/jjco/hym099
  15. Tan PH, Jayabaskar T, Chuah KL, et al (2005). Phyllodes tumors of the breast: the role of pathologic parameters. Am J Clin Pathol, 123, 529-40. https://doi.org/10.1309/U6DVBFM81MLJC1FN
  16. Tavassoli FA, Devilee P (2003). Pathology and genetics of tumours of the breast and female genital organs. World Health Organization Classification of Tumours. Lyon France: IARC Press.
  17. Serey VH, Kim ES and Monchy D (2011). Preliminary data about female malignant breast tumors in Cambodia. Asian Pac J Cancer Prev, 12, 383-5.
  18. Wei J, Tan YT, Cai YC, et al (2014). Predictive factors for the local recurrence and distant metastasis of phyllodes tumors of the breast: a retrospective analysis of 192 cases at a single center. Chin J Cancer, 33, 492-500.
  19. World Health Organization (1981). Histologic typing of breast tumors. Tumori, 67, 253-72.

피인용 문헌

  1. Phyllodes tumours of the breast: a consensus review vol.68, pp.1, 2015, https://doi.org/10.1111/his.12876
  2. Local Recurrence of Benign, Borderline, and Malignant Phyllodes Tumors of the Breast: A Systematic Review and Meta-analysis pp.1534-4681, 2019, https://doi.org/10.1245/s10434-018-07134-5