title: Phyllodes tumor of the breast.
abstract: OBJECTIVE
  To better identify prognostic factors for local control and survival, as well as the role of different therapeutic options, for phyllodes tumors, a rare fibroepithelial neoplasm of the breast.
  
  
  METHODS
  Data from 443 women treated between 1971 and 2003 were collected from the Rare Cancer Network. The median age was 40 years (range, 12-87 years). Tumors were benign in 284 cases (64%), borderline in 80 cases (18%), and malignant in 79 cases (18%). Surgery consisted of breast-conserving surgery (BCS) in 377 cases (85%) and total mastectomy (TM) in 66 cases (15%). Thirty-nine patients (9%) received adjuvant radiotherapy (RT).
  
  
  RESULTS
  After a median follow-up of 106 months, local recurrence (LR) and distant metastases rates were 19% and 3.4%, respectively. In the malignant and borderline group (n = 159), RT significantly decreased LR (p = 0.02), and TM had better results than BCS (p = 0.0019). Multivariate analysis revealed benign histology, negative margins, and no residual disease (no RD) after initial treatment and RT delivery as independent favorable prognostic factors for local control; benign histology and low number of mitosis for disease-free survival; and pathologic tumor size < or = 3 cm and no tumor necrosis for overall survival. In the malignant and borderline subgroup multivariate analysis TM was the only favorable independent prognostic factor for disease-free survival.
  
  
  CONCLUSIONS
  This study showed that phyllodes tumor patients with no RD after treatment have better local control. Benign tumors have a good prognosis after surgery alone. In borderline and malignant tumors, TM had better results than BCS. Thus, in these forms adjuvant RT should be considered according to histologic criteria.
authors.affiliation: Centre Oscar Lambret, Lille, France. y-belkacemi@o-lambret.fr
authors.forename: Yazid
authors.initials: Y
authors.lastname: Belkacémi
authors.forename: Guilhem
authors.initials: G
authors.lastname: Bousquet
authors.forename: Hugo
authors.initials: H
authors.lastname: Marsiglia
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ray-Coquard
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
authors.forename: Yann
authors.initials: Y
authors.lastname: Malard
authors.forename: Magalie
authors.initials: M
authors.lastname: Lacroix
authors.forename: Cristina
authors.initials: C
authors.lastname: Gutierrez
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Senkus
authors.forename: David
authors.initials: D
authors.lastname: Christie
authors.forename: Karen
authors.initials: K
authors.lastname: Drumea
authors.forename: Edouard
authors.initials: E
authors.lastname: Lagneau
authors.forename: Sidney P
authors.initials: SP
authors.lastname: Kadish
authors.forename: Luciano
authors.initials: L
authors.lastname: Scandolaro
authors.forename: David
authors.initials: D
authors.lastname: Azria
authors.forename: Mahmut
authors.initials: M
authors.lastname: Ozsahin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D003557:Phyllodes Tumor / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate