Tuesday, November 13, 2018

Management of #Malignant Phyllodes #Tumours of the Breast by Ern Yu Tan in BJSTR

Abstract


Background: #Malignantphyllodes #tumours are rare cancers of the breast. #Surgery is the primary mode of treatment and current adjuvant treatments appear ineffective. Survival is extremely poor when distant #metastasis develops.

Aim: We retrospectively reviewed 30 women who underwent surgery for malignant phyllodes tumours at our unit over a 16-year period. Clinical outcome, particularly the development of distant metastasis, was examined and factors associated with distant metastasis were evaluated.

Results:Median age was 55 years. All but 2 women presented with a palpable breast mass, which was larger than 10cm in 8. In total, 21 women underwent mastectomy and 9 a wide local excision. Margins remained involved in 4 women even after a #mastectomy and 3 received post-operative #radiation. Distant metastasis was found in 1 woman on staging scans done in the immediate post-operative period and in another 6 women a median of 5.3 months after surgery. None received #chemotherapy and median survival after the development of distant metastasis was 2.2 months. Surgical margin involvement was the only factor associated with distant metastasis (P = 0.031, OR 16.499, 95% CI 0.005 to 0.740), but was not significant after adjusting for tumour size (P = 0.135, OR 8.348, 95% CI 0.518 to 134.650). Overall survival was 25.5 months and was strongly associated with distant metastasis (P <0.001, HR495.1, 95%CI 55.84 to 4390).

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