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Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 1/2022

22.07.2021 | Breast Oncology

Phyllodes Tumors: A Scoping Review of the Literature

verfasst von: Jessica Bogach, MD, MSc, Saad Shakeel, MD, MPH, Frances C. Wright, MD, MEd, Nicole J. Look Hong, MD, MSc

Erschienen in: Annals of Surgical Oncology | Ausgabe 1/2022

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Abstract

Purpose

Phyllodes tumors are rare tumors of the breast, with most literature being retrospective with limited guidelines on the management of these patients. Scoping review was performed to highlight themes and gaps in the available literature.

Methods

A scoping review of the literature was performed as per PRISMA-ScR guidelines with titles, abstracts, and full texts reviewed in duplicate. Data were abstracted and summarized in categories of diagnostics, surgical management, adjuvant therapies, treatment of recurrence, and surveillance. Quality assessment was performed for each paper.

Results

The search identified 4498 references, 434 full-text papers were reviewed, and 183 papers were included. Ultrasound, magnetic resonance imaging, and core needle biopsy are valuable preoperative diagnostics tools. Pathology reporting should include stromal overgrowth, stromal cellularity, nuclear atypia, mitotic rate, borders, and presence of heterologous elements. Ki67 may have a role in grading and prognosticating. Breast conservation is safe in all grades of phyllodes but may be associated with increased local recurrence in malignant phyllodes. Surgical margins should depend on grade. Axillary node positivity rate is very low, even with clinically enlarged lymph nodes. Adjuvant radiation is a useful tool to decrease local recurrence in malignant phyllodes tumors, tumors > 5 cm, age < 45 years, close margins, and breast conservation. There is no evidence supporting adjuvant chemotherapy. Recurrence can be managed with repeat wide excision; however, mastectomy is associated with lower re-recurrence. Surveillance protocols are variable in the literature.

Conclusions

There is heterogeneity in the literature on phyllodes tumors. Consensus guidelines based on the literature will help provide evidence-based care.
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Metadaten
Titel
Phyllodes Tumors: A Scoping Review of the Literature
verfasst von
Jessica Bogach, MD, MSc
Saad Shakeel, MD, MPH
Frances C. Wright, MD, MEd
Nicole J. Look Hong, MD, MSc
Publikationsdatum
22.07.2021
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 1/2022
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-021-10468-2

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