title: Clinicopathologic risk factors for the local recurrence of phyllodes tumors of the breast.
abstract: BACKGROUND
  Phyllodes tumors (PTs) are rare breast tumors that usually occur in middle-aged women. Here we discuss our recent experiences in the diagnosis, surgical management, and clinical follow-up of this disease.
  
  
  METHODS
  We retrospectively reviewed 164 patients with PTs who underwent surgical treatment at the Department of Surgery, Samsung Medical Center, Seoul, Korea, from January 1995 to July 2009. Clinical and histopathological data were analyzed.
  
  
  RESULTS
  The median follow-up period was 33.6 months (range 2-179 months), and the median patient age was 43 years (range of 11-72 years). Tumor size ranged from 1 to 30 cm, with a median of 6.1 cm. A total of 148 patients (90.2 %) received local or wide excisions. Mastectomies were performed in 16 patients (9.8 %). The pathologic diagnoses included 82 benign (50.0 %), 42 borderline (25.6 %), and 40 malignant PTs (24.4 %). The tumor border was infiltrating in 43 patients (26.2 %) and pushing in 116 patients (70.7 %). The resection margin was divided by based on the width. Local recurrence was observed in 31 patients (18.9 %), and distant metastasis developed in four patients with malignant PTs. Risk factors for the local recurrence of a PT were a positive resection margin (P = .029) and tumor size (P = .001).
  
  
  CONCLUSIONS
  The presence of tumor cells on the resection margin was a strong prognostic factor for local recurrence of PTs. However, a 1 cm negative margin thickness did not confer any local control advantage over a thinner negative margin width.
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jae Hyuck
authors.initials: JH
authors.lastname: Jang
authors.forename: Min-Young
authors.initials: MY
authors.lastname: Choi
authors.forename: Se Kyung
authors.initials: SK
authors.lastname: Lee
authors.forename: Sangmin
authors.initials: S
authors.lastname: Kim
authors.forename: Jiyoung
authors.initials: J
authors.lastname: Kim
authors.forename: Jeonghui
authors.initials: J
authors.lastname: Lee
authors.forename: Seung Pil
authors.initials: SP
authors.lastname: Jung
authors.forename: Jun-Ho
authors.initials: JH
authors.lastname: Choe
authors.forename: Jung-Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Jee Soo
authors.initials: JS
authors.lastname: Kim
authors.forename: Eun Yoon
authors.initials: EY
authors.lastname: Cho
authors.forename: Jeong Eon
authors.initials: JE
authors.lastname: Lee
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Nam
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy / Q000009:adverse effects*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000473:pathology*; D009367:Neoplasm Staging; D003557:Phyllodes Tumor / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult