title: Benign phyllodes tumours of the breast: (Over) treatment of margins - A literature review.
abstract: BACKGROUND
  Phyllodes tumours form a small group of fibroepithelial breast lesions (2-3%). They are classified as benign, borderline, or malignant. (1). Benign phyllodes tumours are the largest subgroup of phyllodes tumours (50-80%), (2) A margin of 1 cm has been suggested as standard of care for all groups of phyllodes tumours.3-6METHODS: We performed a literature review from January 2009 to April 2016 including the non-English literature. We compared studies taking a 1 mm margin, 10 mm margin and studies with focal margin involvement.
  
  
  RESULTS
  We included 12 studies with overall 1702 patients. The range of therapeutic margins differed widely between studies. There is no consensus between studies what constitutes a clear or involved margin. There was a high percentage of margin involvement for benign phyllodes tumours (7.6-43.7%). Despite these inconsistencies, the recurrence rate after excision of benign phyllodes tumours was low in most studies (112 recurrences of 1052 benign phyllodes tumours - 11%; range 0-43%). There is no difference of the recurrence rate between studies aiming for a 10 mm margin (7.9%) compared to a 1 mm margin (5.7%) (p 0.124). The recurrence rate increases when there are tumour cells at the margin (12.9%) (p 0.006).
  
  
  CONCLUSIONS
  There is no difference in recurrence rates between a 1 and a 10 mm margin. 1 mm is an acceptable margin for benign phyllodes tumours. The recurrence rate increases if there is focal margin involvement.
authors.affiliation: Breast Unit, North Cumbria University Hospitals, Newtown Road, Carlisle, Cumbria CA2 7HY, UK. Electronic address: dr.mohamed.shaaban@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Shaaban
authors.affiliation: Breast Unit, North Cumbria University Hospitals, Newtown Road, Carlisle, Cumbria CA2 7HY, UK.
authors.forename: L
authors.initials: L
authors.lastname: Barthelmes
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D000072662:Margins of Excision; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D018365:Neoplasm, Residual; D003557:Phyllodes Tumor / Q000473:pathology / Q000601:surgery*
keywords: Benign; Margins; Overtreatment; Phyllodes tumours; Recurrence