Retrospective review of benign phyllodes cases to analyse treatment, follow-up practice and factors predictive of local recurrence.
Association of Breast Surgery ePoster Library. Padmanabhan P. 05/13/19; 257074; P030
Ms. Pooja Padmanabhan
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Abstract
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P030
Topic: Benign disease
Introduction - Phyllodes tumours are rare fibroepithelial
tumours, traditionally described to have high rates of local recurrence (LR).
There is no consensus regarding margins of excision. Our aim was to ascertain
our practice and factors contributing to LR. Methods - Retrospective data collection from electronic
patient records for cases identified from pathology data base from January 2000
to June 2018. Fisher's exact test used to calculate p values to define factors
associated with LR. Results: - We identified 317 cases of phyllodes of which 155 were benign. 14 had incomplete data, hence 141 were included. Mean age was 42yrs and follow-up 35 months. Three underwent mastectomy, 62 WLEs, 73 enucleation and 6 vacuum assisted excision. Mean size was 39mm (Range 8 - 250 mm). Margins were not specified in 10. Seventeen had LR (12.1%) at mean of 45 months from primary surgery. Age, tumour size (3cm and 5cm cut offs) and type of surgery (WLE + Mastectomy verses enucleation or less) were not associated with LR, Completeness of excision was the only significant factor (p value 0.0052). 16 LRs were symptomatic - 2 malignant, 2 borderline and 7 multiple eventually requiring mastectomy. Follow-up recommended to 89; 39 clinical and radiological, 17 radiological and rest, only clinical. Duration of follow-up
recommended was variable.Conclusion - LR rates for benign phyllodes are low overall.
Completeness of excision is significantly associated with LR. Being breast
aware might be more useful than regular follow-ups as most LRs were symptomatic.
We could use this information to guide local practice.
Topic: Benign disease
Introduction - Phyllodes tumours are rare fibroepithelial
tumours, traditionally described to have high rates of local recurrence (LR).
There is no consensus regarding margins of excision. Our aim was to ascertain
our practice and factors contributing to LR. Methods - Retrospective data collection from electronic
patient records for cases identified from pathology data base from January 2000
to June 2018. Fisher's exact test used to calculate p values to define factors
associated with LR. Results: - We identified 317 cases of phyllodes of which 155 were benign. 14 had incomplete data, hence 141 were included. Mean age was 42yrs and follow-up 35 months. Three underwent mastectomy, 62 WLEs, 73 enucleation and 6 vacuum assisted excision. Mean size was 39mm (Range 8 - 250 mm). Margins were not specified in 10. Seventeen had LR (12.1%) at mean of 45 months from primary surgery. Age, tumour size (3cm and 5cm cut offs) and type of surgery (WLE + Mastectomy verses enucleation or less) were not associated with LR, Completeness of excision was the only significant factor (p value 0.0052). 16 LRs were symptomatic - 2 malignant, 2 borderline and 7 multiple eventually requiring mastectomy. Follow-up recommended to 89; 39 clinical and radiological, 17 radiological and rest, only clinical. Duration of follow-up
recommended was variable.Conclusion - LR rates for benign phyllodes are low overall.
Completeness of excision is significantly associated with LR. Being breast
aware might be more useful than regular follow-ups as most LRs were symptomatic.
We could use this information to guide local practice.
P030
Topic: Benign disease
Introduction - Phyllodes tumours are rare fibroepithelial
tumours, traditionally described to have high rates of local recurrence (LR).
There is no consensus regarding margins of excision. Our aim was to ascertain
our practice and factors contributing to LR. Methods - Retrospective data collection from electronic
patient records for cases identified from pathology data base from January 2000
to June 2018. Fisher's exact test used to calculate p values to define factors
associated with LR. Results: - We identified 317 cases of phyllodes of which 155 were benign. 14 had incomplete data, hence 141 were included. Mean age was 42yrs and follow-up 35 months. Three underwent mastectomy, 62 WLEs, 73 enucleation and 6 vacuum assisted excision. Mean size was 39mm (Range 8 - 250 mm). Margins were not specified in 10. Seventeen had LR (12.1%) at mean of 45 months from primary surgery. Age, tumour size (3cm and 5cm cut offs) and type of surgery (WLE + Mastectomy verses enucleation or less) were not associated with LR, Completeness of excision was the only significant factor (p value 0.0052). 16 LRs were symptomatic - 2 malignant, 2 borderline and 7 multiple eventually requiring mastectomy. Follow-up recommended to 89; 39 clinical and radiological, 17 radiological and rest, only clinical. Duration of follow-up
recommended was variable.Conclusion - LR rates for benign phyllodes are low overall.
Completeness of excision is significantly associated with LR. Being breast
aware might be more useful than regular follow-ups as most LRs were symptomatic.
We could use this information to guide local practice.
Topic: Benign disease
Introduction - Phyllodes tumours are rare fibroepithelial
tumours, traditionally described to have high rates of local recurrence (LR).
There is no consensus regarding margins of excision. Our aim was to ascertain
our practice and factors contributing to LR. Methods - Retrospective data collection from electronic
patient records for cases identified from pathology data base from January 2000
to June 2018. Fisher's exact test used to calculate p values to define factors
associated with LR. Results: - We identified 317 cases of phyllodes of which 155 were benign. 14 had incomplete data, hence 141 were included. Mean age was 42yrs and follow-up 35 months. Three underwent mastectomy, 62 WLEs, 73 enucleation and 6 vacuum assisted excision. Mean size was 39mm (Range 8 - 250 mm). Margins were not specified in 10. Seventeen had LR (12.1%) at mean of 45 months from primary surgery. Age, tumour size (3cm and 5cm cut offs) and type of surgery (WLE + Mastectomy verses enucleation or less) were not associated with LR, Completeness of excision was the only significant factor (p value 0.0052). 16 LRs were symptomatic - 2 malignant, 2 borderline and 7 multiple eventually requiring mastectomy. Follow-up recommended to 89; 39 clinical and radiological, 17 radiological and rest, only clinical. Duration of follow-up
recommended was variable.Conclusion - LR rates for benign phyllodes are low overall.
Completeness of excision is significantly associated with LR. Being breast
aware might be more useful than regular follow-ups as most LRs were symptomatic.
We could use this information to guide local practice.
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