Current clinical practice in the management of phyllodes tumors of the breast: an international cross-sectional study among surgeons and oncologists.

Autor: Sars C; Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden. carl.sars@ki.se., Sackey H; Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.; Division of Cancer, Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital Stockholm, Stockholm, Sweden., Frisell J; Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.; Division of Cancer, Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital Stockholm, Stockholm, Sweden., Dickman PW; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden., Karlsson F; Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.; Division of Cancer, Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital Stockholm, Stockholm, Sweden., Kindts I; General Hospital Groeninge, Kortrijk, Belgium., Marta GN; Department of Radiation Oncology, Hospital Sírio-Libanês, São Paulo, Brazil., Freitas-Junior R; CORA Advanced Center for Diagnosis of Breast Diseases, Hospital das Clínicas, Federal University of Goias, Goiânia, Brazil., Tvedskov TF; Department of Breast Surgery, Gentofte Hospital, Copenhagen, Denmark., Kassem L; Department of Clinical Oncology, Cairo University Hospitals, Cairo, Egypt., Ali AS; Department of Clinical Oncology, Cairo University Hospitals, Cairo, Egypt., Ihalainen H; Comprehensive Cancer Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Neron M; Institut du Cancer de Montpellier, Surgical Oncology Department, Université Montpellier, Montpellier, France., Kontos M; 1st Department of Surgery, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece., Kaidar-Person O; Breast Radiation Unit, Sheba Tel Hashomer, Ramat Gan, Israel.; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel., Meattini I; Department of Experimental and Clinical Biomedical Sciences 'M. Serio', University of Florence, Florence, Italy.; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy., Francken AB; Department of Surgery, Isala Clinics, Zwolle, The Netherlands., van Duijnhoven F; Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Moberg IO; Department of Breast and Endocrine Surgery, Oslo University Hospital Ullevål, Oslo, Norway., Marinko T; Institute of Oncology, Ljubljana, Slovenia.; Medical Faculty, University of Ljubljana, Ljubljana, Slovenia., Kollar A; Department of Medical Oncology, Inselspital, Bern University Hospital, Bern, Switzerland., Ahmed M; University College London Hospitals NHS Foundation Trust, London, UK., Remoundos D; Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Banks J; South West Peninsula Deanery, Devon, UK., Jagsi R; Department of Radiation Oncology, University of Michigan, Ann Arbor, USA., Dossett LA; Department of Surgery, University of Michigan, Ann Arbor, USA., Lindqvist EK; Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet, Stockholm, Sweden.; Department of Surgery, Stockholm South General Hospital, Stockholm, Sweden.
Jazyk: angličtina
Zdroj: Breast cancer research and treatment [Breast Cancer Res Treat] 2023 Jun; Vol. 199 (2), pp. 293-304. Date of Electronic Publication: 2023 Mar 06.
DOI: 10.1007/s10549-023-06896-1
Abstrakt: 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.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz: