Phyllodes Tumors of the Breast: Recurrence and the Importance of Clinical Follow-up

Öz

AIM: Phyllodes tumors, including benign and borderline types, have a substantial potential for recurrence. The objective of this study was to evaluate histologic features that can help predict recurrences, and to emphasize the importance of close follow-up in this regard. MATERIAL AND METHOD: The demographic, clinicopathological characteristics, treatment approaches, and follow-up data of the 64 patients who were treated between 2006 and 2018 at the Istanbul University, Institute of Oncology with the diagnosis of phyllodes tumors were evaluated retrospectively by examining the patient files and pathology records. RESULTS: The median age was 38.8±12.2. The median tumor size was 53.1 mm (range, 11 mm to 210 mm). The phyllodes tumors were classified as follows: benign (n= 36, 56.3%), borderline (n= 11, 17.2%), and malign (n= 17, 26.6%). High mitotic number, cellular pleomorphism, stromal overgrowth, tumoral heterogeneity, and tumor margin irregularity were found to be independent prognostic factors in the development of local recurrence. The common feature of tumor recurrence in the process of benign and borderline phyllodes tumors was tumor margin irregularity. The mean period of recurrence of phyllodes tumors was determined as 29.7 months (range, 10 to 64). In the study, 7 out of 10 recurrences were observed when excision was performed with an insufficient surgical margin of closer than 1 cm, and in three cases when a clear surgical margin was obtained far than 1 cm (p= 0.045). CONCLUSION: Phyllodes tumors were classified as benign, borderline, and malignant. A negative surgical margin of ≥1cm plays a major role in the management of phyllodes tumors. The study may emphasize the importance of close follow-up, given that the recurrence period is short, especially if tumor margin irregularity is detected on definitive pathological examination, even if it is benign or borderline type. Keywords: Phyllodes tumor, breast surgery, margin status

Anahtar Kelimeler

• Phyllodes tumor
• breast surgery
• margin status

Destekleyen Kurum

Herhangi bir kurum tarafından desteklenmemiştir.

Etik Beyan

Bu çalışmanın, özgün bir çalışma olduğunu; çalışmanın hazırlık, veri toplama, analiz ve bilgilerin sunumu olmak üzere tüm aşamalarından bilimsel etik ilke ve kurallarına uygun davrandığımı; bu çalışma kapsamında elde edilmeyen tüm veri ve bilgiler için kaynak gösterdiğimi ve bu kaynaklara kaynakçada yer verdiğimi; kullanılan verilerde herhangi bir değişiklik yapmadığımı, çalışmanın Committee on Publication Ethics (COPE)' in tüm şartlarını ve koşullarını kabul ederek etik görev ve sorumluluklara riayet ettiğimi beyan ederim. Herhangi bir zamanda, çalışmayla ilgili yaptığım bu beyana aykırı bir durumun saptanması durumunda, ortaya çıkacak tüm ahlaki ve hukuki sonuçlara razı olduğumu bildiririm.

Teşekkür

Çalışmamıza önerileriyle destek veren Doç. Dr. Süleyman Bademler'e teşekkür ederiz

Memenin filloid tümörleri: Nüks ve klinik takibin önemi

Öz

AMAÇ: Benign ve borderline tipleri de dahil olmak üzere filloid tümörlerin önemli bir nüks potansiyeli vardır. Bu çalışmanın amacı nüksleri öngörmeye yardımcı olabilecek histolojik özellikleri değerlendirmek ve bu konuda yakın takibin önemini vurgulamaktır. GEREÇ VE YÖNTEM: Çalışmada 2006-2018 yılları arasında İstanbul Üniversitesi Onkoloji Enstitüsü’nde filloid tümör tanısıyla tedavi edilen 64 hastanın demografik, klinikopatolojik özellikleri, tedavi yaklaşımları ve takip verileri hasta dosyaları ve patoloji kayıtları üzerinden retrospektif olarak incelenerek değerlendirildi. BULGULAR: Ortanca yaş 38,8±12,2 idi. Medyan tümör boyutu 53,1 mm idi (medyan 11- 210 mm). Filloid tümörler şu şekilde sınıflandırıldı: Benign (n=36, %56,3), borderline (n= 11, %17,2) ve malign (n= 17, %26,6). Yüksek mitotik sayı, hücresel pleomorfizm, stromal aşırı büyüme, tümöral heterojenite ve tümör sınırı düzensizliğinin lokal nüks gelişiminde bağımsız prognostik faktörler olduğu bulundu. Benign ve borderline filloid tümörlerde nüksün ortak özelliği tümör sınırı düzensizliğiydi. Filloid tümörlerin ortalama tekrarlama süresi 29,7 ay (medyan, 10-64 ay) olarak belirlendi. Çalışmada 1 cm'den daha yakın yetersiz cerrahi sınır ile eksizyon yapıldığında 10 olgudan 7'sinde, 1 cm'den uzakta temiz cerrahi sınır elde edilen üç olguda ise nüks gözlendi (p= 0,045). SONUÇ: Filloid tümörler benign, borderline ve malign olarak sınıflandırıldı. Tedavisinde ≥1 cm'lik negatif cerrahi sınır önemli bir rol oynar. Çalışmamız, nüks süresinin kısa olması nedeniyle, özellikle benign veya borderline tipte olsa bile, kesin patolojik incelemede tümör sınırında düzensizlik saptanması durumunda yakın takibin önemini vurgulamaktadır.

Anahtar Kelimeler

• Fillides tümör
• meme cerrahisi
• cerrahi sınır

Kaynakça

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