Surgical Management of Benign and Borderline Phyllodes Tumors of the Breast.
Phyllodes tumors (PT) are uncommon fibroepithelial breast neoplasms and there is currently no clear consensual treatment for these tumors. The aim of our study was to evaluate the surgical management and outcome of benign and borderline PT. We retrospectively assessed 76 cases of benign or borderline PT managed at the Leon Berard comprehensive cancer center in Lyon, France between July 2003 and December 2013. The mean age at diagnosis was 37.9 years and the median follow-up was 58 months. Seventy-five patients (99%), with a mean tumor size of 27 mm, underwent a breast-conserving procedure. The tumor margins were considered positive (when the tumor was present at the inked surgical section) in seven of 76 cases (9%) and negative in 65 out of 76 cases (86%). We observed the presence of small negative surgical margins <10 mm in 89% and <1 mm in 71% of the patients. Although no re-excision was performed to increase these margins, we did not see any increase in the local recurrence rate (4%) when compared to recurrence rates reported in the literature. We thus suggest that systematic revision surgery for close or positive surgical margins for benign PT should not be systematically performed. However, as recurrences occur within 2 years of initial excision, we recommend a regular clinical and imaging follow-up especially during this period for which patient's compliance is essential.
Department of Surgical Oncology, Léon Bérard Comprehensive Cancer Center, Lyon Cedex, France.
Amandine
A
Moutte
Department of Surgical Oncology, Léon Bérard Comprehensive Cancer Center, Lyon Cedex, France.
Nicolas
N
Chopin
Department of Surgical Oncology, Léon Bérard Comprehensive Cancer Center, Lyon Cedex, France.
Christelle
C
Faure
Department of Surgical Oncology, Léon Bérard Comprehensive Cancer Center, Lyon Cedex, France.
Frédéric
F
Beurrier
Department of Surgical Oncology, Léon Bérard Comprehensive Cancer Center, Lyon Cedex, France.
Christophe
C
Ho Quoc
Department of Surgical Oncology, Léon Bérard Comprehensive Cancer Center, Lyon Cedex, France.
Florence
F
Guinaudeau
Department of Histopathology, Léon Bérard Comprehensive Cancer Center, Lyon Cedex, France.
Isabelle
I
Treilleux
Department of Surgical Oncology, Léon Bérard Comprehensive Cancer Center, Lyon Cedex, France.|Department of Sugery, Charcot Clinic, Sainte Foy Les Lyon, France.
Nicolas
N
Carrabin
D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D003557:Phyllodes Tumor / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult
benign phyllode tumor; borderline phyllode tumor; surgical margins