Current clinical practice in the management of phyllodes tumors of the breast: an international cross-sectional study among surgeons and oncologists
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Published:2023-03-06
Issue:2
Volume:199
Page:293-304
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ISSN:0167-6806
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Container-title:Breast Cancer Research and Treatment
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language:en
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Short-container-title:Breast Cancer Res Treat
Author:
Sars CarlORCID, Sackey Helena, Frisell Jan, Dickman Paul W., Karlsson Fredrik, Kindts Isabelle, Marta Gustavo Nader, Freitas-Junior Ruffo, Tvedskov Tove Filtenborg, Kassem Loay, Ali Ahmed S., Ihalainen Hanna, Neron Mathias, Kontos Michalis, Kaidar-Person Orit, Meattini Icro, Francken Anne Brecht, van Duijnhoven Frederieke, Moberg Ingvild Ona, Marinko Tanja, Kollar Attila, Ahmed Mahbubl, Remoundos Dennis, Banks Jenny, Jagsi Reshma, Dossett Lesly A., Lindqvist Ebba K.
Abstract
Abstract
Purpose
Phyllodes tumors of the breast are rare fibroepithelial lesions that are classified as benign, borderline or malignant. There is little consensus on best practice for the work-up, management, and follow-up of patients with phyllodes tumors of the breast, and evidence-based guidelines are lacking.
Methods
We conducted a cross-sectional survey of surgeons and oncologists with the aim to describe current clinical practice in the management of phyllodes tumors. The survey was constructed in REDCap and distributed between July 2021 and February 2022 through international collaborators in sixteen countries across four continents.
Results
A total of 419 responses were collected and analyzed. The majority of respondents were experienced and worked in a university hospital. Most agreed to recommend a tumor-free excision margin for benign tumors, increasing margins for borderline and malignant tumors. The multidisciplinary team meeting plays a major role in the treatment plan and follow-up. The vast majority did not consider axillary surgery. There were mixed opinions on adjuvant treatment, with a trend towards more liberal regiments in patients with locally advanced tumors. Most respondents preferred a five-year follow-up period for all phyllodes tumor types.
Conclusions
This study shows considerable variation in clinical practice managing phyllodes tumors. This suggests the potential for overtreatment of many patients and the need for education and further research targeting appropriate surgical margins, follow-up time and a multidisciplinary approach. There is a need to develop guidelines that recognize the heterogeneity of phyllodes tumors.
Funder
Karolinska Institute
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Oncology
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