Benign phyllodes tumours of the breast: (Over) Treatment of margins – a literature review

Publication date: Available online 5 November 2016
Source:European Journal of Surgical Oncology (EJSO)
Author(s): M. Shaaban, L. Barthelmes
BackgroundPhyllodes tumours form a small group of fibroepithelial breast lesions (2-3 %). They are classified as benign, borderline, or malignant. (1). Benign phyllodes tumours are the largest subgroup of phyllodes tumours (50 - 80%), (2) A margin of 1 cm has been suggested as standard of care for all groups of phyllodes tumours (3) (4) (5) (6).MethodsWe performed a literature review from January 2009 to April 2016 including the non-English literature. We compared studies taking a 1 mm margin, 10 mm margin and studies with focal margin involvement.ResultsWe included 12 studies with overall 1702 patients. The range of therapeutic margins differed widely between studies. There is no consensus between studies what constitutes a clear or involved margin. There was a high percentage of margin involvement for benign phyllodes tumours (7.6 – 43.7 %). Despite these inconsistencies, the recurrence rate after excision of benign phyllodes tumours was low in most studies (112 recurrences of 1052 benign phyllodes tumours - 11 %; range 0 – 43 %). There is no difference of the recurrence rate between studies aiming for a 10 mm margin (7.9%) compared to a 1 mm margin (5.7%) (p 0.124). The recurrence rate increases when there are tumour cells at the margin (12.9 %) (p 0.006)ConclusionThere is no difference in recurrence rates between a 1 and a 10 mm margin. 1 mm is an acceptable margin for benign phyllodes tumours. The recurrence rate increases if there is focal margin involvement.



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