The Analysis Study Of Diagnosis And Surgical Management Of Phyllodes Tumor : A Comprehensive Systematic Review

Surya Martua Horas


Abstract


 

Background: Phyllodes tumor (PT) is a rare form of breast tumor with a diverse range of behaviors based on pathological characteristics. It is classified into benign, borderline, and malignant types, with only those classified as borderline or malignant known to metastasize. PTs typically present as palpable breast lumps or are discovered through ultrasound examinations. Diagnosis involves core needle biopsy, mammography, ultrasound, and breast MRI. Primary treatment involves surgical excision, with adjuvant treatments reserved for borderline or malignant tumors. Methods: Following PRISMA 2020 guidelines, this systematic review focused exclusively on full-text articles published in English between 2014 and 2024. To ensure the inclusion of high-quality sources, editorial pieces and review articles were excluded unless they were accompanied by a DOI. The literature search was conducted using several reputable databases, including ScienceDirect, PubMed, and SagePub, to comprehensively gather relevant studies. Result: The study conducted a comprehensive review of over 200 publications sourced from reputable databases, including ScienceDirect, SagePub, and PubMed. Following an initial screening, eight publications were identified as warranting more in-depth analysis. Consequently, a thorough review of these selected studies was performed to ensure a detailed and rigorous evaluation. Conclusion: Phyllodes tumors, a rare fibroepithelial cancer, are typically found in women aged 45-49. They present as painless, rapidly growing masses, with malignant tumors exhibiting a higher risk of recurrence. Surgical management is crucial to achieve a negative margin, with RT being considered for malignant tumors after wide excision

Keywords


phyllodes tumor, breast tumor, surgical management

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Abdul Hamid, S., Rahmat, K., Ramli, M. T., Fadzli, F., Jamaris, S., See, M. H., Teoh, K. H., & Taib, N. A. M. (2018). Radiopathological characteristics and outcomes of phyllodes tumor of the breast in Malaysian women. Medicine, 97(31), e11412. https://doi.org/10.1097/MD.0000000000011412

Adesoye, T., Neuman, H. B., Wilke, L. G., Schumacher, J. R., Steiman, J., & Greenberg, C. C. (2016). Current Trends in the Management of Phyllodes Tumors of the Breast. Annals of surgical oncology, 23(10), 3199–3205. https://doi.org/10.1245/s10434-016-5314-0

Atram, M., Gupta, A., & Gangane, N. M. (2022). Malignant Phyllodes Tumor with Heterologous Sarcomatous Differentiation: a Case Series and Review of Literature. Indian journal of surgical oncology, 13(4), 723–730. https://doi.org/10.1007/s13193-022-01525-7

Barrio, A. V., Clark, B. D., Goldberg, J. I., Hoque, L. W., Bernik, S. F., Flynn, L. W., Susnik, B., Giri, D., Polo, K., Patil, S., & Van Zee, K. J. (2007). Clinicopathologic features and long-term outcomes of 293 phyllodes tumors of the breast. Annals of surgical oncology, 14(10), 2961–2970. https://doi.org/10.1245/s10434-007-9439-z

Barrio, A. V., Clark, B. D., Goldberg, J. I., Hoque, L. W., Bernik, S. F., Flynn, L. W., Susnik, B., Giri, D., Polo, K., Patil, S., & Van Zee, K. J. (2007). Clinicopathologic features and long-term outcomes of 293 phyllodes tumors of the breast. Annals of surgical oncology, 14(10), 2961–2970. https://doi.org/10.1245/s10434-007-9439-z

Bernstein, L., Deapen, D., & Ross, R. K. (1993). The descriptive epidemiology of malignant cystosarcoma phyllodes tumors of the breast. Cancer, 71(10), 3020–3024.

Birch, J. M., Alston, R. D., McNally, R. J., Evans, D. G., Kelsey, A. M., Harris, M., Eden, O. B., & Varley, J. M. (2001). Relative frequency and morphology of cancers in carriers of germline TP53 mutations. Oncogene, 20(34), 4621–4628. https://doi.org/10.1038/sj.onc.1204621

Carlson, R. W., Allred, D. C., Anderson, B. O., Burstein, H. J., Edge, S. B., Farrar, W. B., Forero, A., Giordano, S. H., Goldstein, L. J., Gradishar, W. J., Hayes, D. F., Hudis, C. A., Isakoff, S. J., Ljung, B. M., Mankoff, D. A., Marcom, P. K., Mayer, I. A., McCormick, B., Pierce, L. J., Reed, E. C., … National Comprehensive Cancer Network (2012). Metastatic breast cancer, version 1.2012: featured updates to the NCCN guidelines. Journal of the National Comprehensive Cancer Network : JNCCN, 10(7), 821–829. https://doi.org/10.6004/jnccn.2012.0086

Chaney, A. W., Pollack, A., McNeese, M. D., Zagars, G. K., Pisters, P. W., Pollock, R. E., & Hunt, K. K. (2000). Primary treatment of cystosarcoma phyllodes of the breast. Cancer, 89(7), 1502–1511. https://doi.org/10.1002/1097-0142(20001001)89:7<1502::aid-cncr13>3.0.co;2-p

Choi, N., Kim, K., Shin, K. H., Kim, Y., Moon, H. G., Park, W., Choi, D. H., Kim, S. S., Ahn, S. D., Kim, T. H., Chun, M., Kim, Y. B., Kim, S., Choi, B. O., & Kim, J. H. (2019). The Characteristics of Local Recurrence After Breast-Conserving Surgery Alone for Malignant and Borderline Phyllodes Tumors of the Breast (KROG 16-08). Clinical breast cancer, 19(5), 345–353.e2. https://doi.org/10.1016/j.clbc.2019.04.003

Ditsatham, C., & Chongruksut, W. (2019). Phyllodes tumor of the breast: diagnosis, management and outcome during a 10-year experience. Cancer management and research, 11, 7805–7811. https://doi.org/10.2147/CMAR.S215039

Elston, C.W.; Ellis, I.O. The Breast. Systemic Pathology, 3rd ed.; Churchill Livingstone: Edinburgh, UK, 2000; Volume 13, pp. 147–186.

Farria, D. M., Gorczyca, D. P., Barsky, S. H., Sinha, S., & Bassett, L. W. (1996). Benign phyllodes tumor of the breast: MR imaging features. AJR. American journal of roentgenology, 167(1), 187–189. https://doi.org/10.2214/ajr.167.1.8659370

Gatta, G., Iaselli, F., Parlato, V., Di Grezia, G., Grassi, R., & Rotondo, A. (2011). Differential diagnosis between fibroadenoma, giant fibroadenoma and phyllodes tumour: sonographic features and core needle biopsy. La Radiologia medica, 116(6), 905–918. https://doi.org/10.1007/s11547-011-0672-y

Gnerlich, J. L., Williams, R. T., Yao, K., Jaskowiak, N., & Kulkarni, S. A. (2014). Utilization of radiotherapy for malignant phyllodes tumors: analysis of the National Cancer Data Base, 1998-2009. Annals of surgical oncology, 21(4), 1222–1230. https://doi.org/10.1245/s10434-013-3395-6

Guillot, E., Couturaud, B., Reyal, F., Curnier, A., Ravinet, J., Laé, M., Bollet, M., Pierga, J. Y., Salmon, R., Fitoussi, A., & Breast Cancer Study Group of the Institut Curie (2011). Management of phyllodes breast tumors. The breast journal, 17(2), 129–137. https://doi.org/10.1111/j.1524-4741.2010.01045.x

Hanby, A.M., walker, C. Tavassoli FA, Devilee P: Pathology and Genetics: Tumours of the Breast and Female Genital Organs. WHO Classification of Tumours series - volume IV. Lyon, France: IARC Press. Breast Cancer Res 6, 133 (2004). https://doi.org/10.1186/bcr788

Jayaraman, M., V, L., Diwagar, N., & Esakki, M. (2024). Diagnostic Maze: Malignant Phyllodes Tumor Mimicking Metaplastic Breast Carcinoma. Cureus, 16(6), e62114. https://doi.org/10.7759/cureus.62114

Limaiem F, Kashyap S. Phyllodes Tumor of the Breast. [Updated 2023 Jan 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541138/#

Lu, Y., Chen, Y., Zhu, L., Cartwright, P., Song, E., Jacobs, L., & Chen, K. (2019). Local Recurrence of Benign, Borderline, and Malignant Phyllodes Tumors of the Breast: A Systematic Review and Meta-analysis. Annals of surgical oncology, 26(5), 1263–1275. https://doi.org/10.1245/s10434-018-07134-5

Macdonald, O. K., Lee, C. M., Tward, J. D., Chappel, C. D., & Gaffney, D. K. (2006). Malignant phyllodes tumor of the female breast: association of primary therapy with cause-specific survival from the Surveillance, Epidemiology, and End Results (SEER) program. Cancer, 107(9), 2127–2133. https://doi.org/10.1002/cncr.22228

Mishra SP, Tiwary SK, Mishra M, Khanna AK. Phyllodes tumor of breast: a review article. ISRN Surg. 2013;2013:361469. doi: 10.1155/2013/361469. Epub 2013 Mar 20. PMID: 23577269; PMCID: PMC3615633.

Mustață, L., Gică, N., Botezatu, R., Chirculescu, R., Gică, C., Peltecu, G., & Panaitescu, A. M. (2021). Malignant Phyllodes Tumor of the Breast and Pregnancy: A Rare Case Report and Literature Review. Medicina (Kaunas, Lithuania), 58(1), 36. https://doi.org/10.3390/medicina58010036

Norris, H. J., & Taylor, H. B. (1967). Relationship of histologic features to behavior of cystosarcoma phyllodes. Analysis of ninety-four cases. Cancer, 20(12), 2090–2099. https://doi.org/10.1002/1097-0142(196712)20:12<2090::aid-cncr2820201206>3.0.co;2-l

Ossa, C. A., Herazo, F., Gil, M., Echeverri, C., Ángel, G., Borrero, M., Madrid, J., & Jaramillo, R. (2015). Phyllodes tumor of the breast: a clinic-pathologic study of 77 cases in a Hispanic cohort. Colombia medica (Cali, Colombia), 46(3), 104–108.

Ouyang, Q., Li, S., Tan, C., Zeng, Y., Zhu, L., Song, E., Chen, K., & Su, F. (2016). Benign Phyllodes Tumor of the Breast Diagnosed After Ultrasound-Guided Vacuum-Assisted Biopsy: Surgical Excision or Wait-and-Watch?. Annals of surgical oncology, 23(4), 1129–1134. https://doi.org/10.1245/s10434-015-4990-5

Pitsinis, V., Moussa, O., Hogg, F., & McCaskill, J. (2017). Reconstructive and Oncoplastic Surgery for Giant Phyllodes Tumors: A Single Center's Experience. World journal of plastic surgery, 6(2), 233–237




DOI: https://doi.org/10.30743/best.v7i2.10270

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