Skip to main content

Advertisement

SpringerLink
Log in

Benign Phyllodes Tumor of the Breast Diagnosed After Ultrasound-Guided Vacuum-Assisted Biopsy: Surgical Excision or Wait-and-Watch?

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The role of tumor-free resection in the treatment of benign phyllodes tumors (PTs) is still unknown. Ultrasound-guided vacuum-assisted biopsy (UGVAB) has been used for complete removal of benign breast lesions. This retrospective study aimed to compare the risk of relapse between patients with benign PT who undergo UGVAB and those who receive surgical excision (SE).

Methods

Benign PT patients with a pathology diagnosis who had received treatment between 2005 and 2013 at the authors’ hospital were identified. The patients who received UGVAB did not receive any SE. In the SE group, wide local excision or mastectomy was performed when appropriate. The Kaplan–Meier curve and Cox proportional hazards regression were used to analyze and compare the relapse-free survival (RFS) between the patients in the two groups.

Results

The study enrolled 225 female patients with benign PT. The patients in the UGVAB group (n = 108) had significantly smaller tumors, more fibroadenoma, a higher body mass index (BMI), and a lower Breast Imaging-Reporting and Data System classification than the patients in the SE group (n = 117). The 5-year cumulative RFS was 81.6 and 88.7 % (p = 0.11) respectively for the patients receiving UGVAB and SE during a median follow-up period of 35.5 months. After adjustment for age, tumor size, BMI, or presence of fibroadenoma, treatment (UGVAB vs. SE) was not associated with increased risk for relapse events (hazard ratio 0.34; 95 % confidence interval 0.08–1.43; p = 0.14). No distant metastasis or death events occurred.

Conclusions

The patients with benign PT who received UGVAB alone did not have a significantly more compromised RFS than those who underwent SE. A prospective, randomized study is needed to confirm this observation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Tavassoli FA. Pathology and genetics of tumours of the breast and female genital organs. World Health Organization Classification of Tumours. Lyon: IARC Press; 2003. p. 99–103.

    Google Scholar 

  2. NCCN Clinical Practice Guidelines in Oncology. Breast Cancer. Version 2. http://www.nccn.org. Accessed 03 Nov 2015.

  3. Zurrida S, Bartoli C, Galimberti V, et al. Which therapy for unexpected phyllode tumour of the breast? Eur J Cancer. 1992;28:654–7.

    Article  CAS  PubMed  Google Scholar 

  4. Grady I, Gorsuch H, Wilburn-Bailey S. Long-term outcome of benign fibroadenomas treated by ultrasound-guided percutaneous excision. Breast J. 2008;14:275–8.

    Article  PubMed  Google Scholar 

  5. Meyer JE, Smith DN, Lester SC, et al. Large-core needle biopsy of non palpable breast lesions. JAMA. 1999;281:1638–41.

    Article  CAS  PubMed  Google Scholar 

  6. Li S, Wu J, Chen K, et al. Clinical outcomes of 1578 Chinese patients with breast benign diseases after ultrasound-guided vacuum-assisted excision: recurrence and the risk factors. Am J Surg. 2013;205:39–44.

    Article  PubMed  Google Scholar 

  7. Park HL, Kwon SH, Chang SY, et al. Long-term follow-up result of benign phyllodes tumor of the breast diagnosed and excised by ultrasound-guided vacuum-assisted breast biopsy. J Breast Cancer. 2012;15:224–9.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Chaney AW, Pollack A, McNeese MD, et al. Primary treatment of cystosarcoma phyllodes of the breast. Cancer. 2000;89:1502–11.

    Article  CAS  PubMed  Google Scholar 

  9. Barrio AV, Clark BD, Goldberg JI, et al. Clinicopathologic features and long-term outcomes of 293 phyllodes tumors of the breast. Ann Surg Oncol. 2007;14:2961–70.

    Article  PubMed  Google Scholar 

  10. Jang JH, Choi MY, Lee SK, et al. Clinicopathologic risk factors for the local recurrence of phyllodes tumors of the breast. Ann Surg Oncol. 2012;19:2612–7.

    Article  PubMed  Google Scholar 

  11. Kim S, Kim JY, Kim DH, Jung WH, Koo JS. Analysis of phyllodes tumor recurrence according to the histologic grade. Breast Cancer Res Treat. 2013.141: 353–363.

    Article  PubMed  Google Scholar 

  12. Tan PH, Jayabaskar T, Chuah KL, et al. Phyllodes tumors of the breast: the role of pathologic parameters. Am J Clin Pathol. 2005;123:529–40.

    Article  PubMed  Google Scholar 

  13. Chen WH, Cheng SP, Tzen CY, et al. Surgical treatment of phyllodes tumors of the breast: retrospective review of 172 cases. J Surg Oncol. 2005;91:185–94.

    Article  PubMed  Google Scholar 

  14. Yom CK, Han W, Kim SW, Park SY, Park IA, Noh DY. Reappraisal of conventional risk stratification for local recurrence based on clinical outcomes in 285 resected phyllodes tumors of the breast. Ann Surg Oncol. 2015;22:2912–8.

    Article  PubMed  Google Scholar 

  15. Burbank F, Parker SH, Fogarty TJ. Stereotactic breast biopsy: improved tissue harvesting with the Mammotome. Am Surg. 1996;62:738–44.

    CAS  PubMed  Google Scholar 

  16. Burbank F, Forcier N. Tissue marking clip for stereotactic breast biopsy: initial placement accuracy, long-term stability, and usefulness as a guide for wire localization. Radiology. 1997;205:407–15.

    Article  CAS  PubMed  Google Scholar 

  17. Benhassouna J, Damak T, Gamoudi A, et al. Phyllodes tumors of the breast: a case series of 106 patients. Am J Surg. 2006;192:141–7.

    Article  PubMed  Google Scholar 

  18. Belkacemi Y, Bousquet G, Marsiglia H, et al. Phyllodes tumor of the breast. Int J Radiat Oncol Biol Phys. 2008;70:492–500.

    Article  PubMed  Google Scholar 

  19. Choi J, Koo JS. Comparative study of histological features between core needle biopsy and surgical excision in phyllodes tumor. Pathol Int. 2012;62:120–6.

    Article  PubMed  Google Scholar 

  20. Bassett LW, Mahoney MC, Apple SK. Interventional breast imaging: current procedures and assessing for concordance with pathology. Radiol Clin North Am. 2007;45:881–94, vii.

    Article  PubMed  Google Scholar 

  21. Jiang Y, Lan H, Ye Q, et al. Mammotome biopsy system for the resection of breast lesions: clinical experience in two high-volume teaching hospitals. Exper Ther Med. 2013;6:759–64.

    Google Scholar 

Download references

Acknowledgment

This study was supported by the National Natural Science Foundation of China (Grant #81402201), the National Natural Science Foundation of Guangdong Province (Grant #2014A030310070), and a Grant [2013]163 from the Key Laboratory of Malignant Tumor Molecular Mechanism and Translational Medicine of Guangzhou Bureau of Science and Information Technology.

Conflict of interest

There are no conflicts of interest.

Author information

Author notes

    Authors and Affiliations

    1. Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China

      Qian Ouyang MD, Shunrong Li MD, Cui Tan MD, Yunjie Zeng MD, Liling Zhu MD, Erwei Song MD, PhD, Kai Chen MD & Fengxi Su MD

    2. Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China

      Qian Ouyang MD, Shunrong Li MD, Liling Zhu MD, Erwei Song MD, PhD, Kai Chen MD & Fengxi Su MD

    3. Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China

      Cui Tan MD & Yunjie Zeng MD

    Authors
    1. Qian Ouyang MD
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Shunrong Li MD
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Cui Tan MD
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Yunjie Zeng MD
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Liling Zhu MD
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Erwei Song MD, PhD
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Kai Chen MD
      View author publications

      You can also search for this author in PubMed Google Scholar

    8. Fengxi Su MD
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding authors

    Correspondence to Kai Chen MD or Fengxi Su MD.

    Additional information

    Qian Ouyang, Shunrong Li, and Cui Tan contributed equally.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Ouyang, Q., Li, S., Tan, C. et al. Benign Phyllodes Tumor of the Breast Diagnosed After Ultrasound-Guided Vacuum-Assisted Biopsy: Surgical Excision or Wait-and-Watch?. Ann Surg Oncol 23, 1129–1134 (2016). https://doi.org/10.1245/s10434-015-4990-5

    Download citation

    • Received:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1245/s10434-015-4990-5

    Keywords

    Search

    Navigation