Current clinical practice in the management of phyllodes tumors of the breast: an international cross-sectional study among surgeons and oncologists
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Current clinical practice in the management of phyllodes tumors of the breast : an international cross-sectional study among surgeons and oncologists. / Sars, Carl; Sackey, Helena; Frisell, Jan; Dickman, Paul W.; Karlsson, Fredrik; Kindts, Isabelle; Marta, Gustavo Nader; Freitas-Junior, Ruffo; Tvedskov, Tove Filtenborg; Kassem, Loay; Ali, Ahmed S.; Ihalainen, Hanna; Neron, Mathias; Kontos, Michalis; Kaidar-Person, Orit; Meattini, Icro; Francken, Anne Brecht; van Duijnhoven, Frederieke; Moberg, Ingvild Ona; Marinko, Tanja; Kollar, Attila; Ahmed, Mahbubl; Remoundos, Dennis; Banks, Jenny; Jagsi, Reshma; Dossett, Lesly A.; Lindqvist, Ebba K.
I: Breast Cancer Research and Treatment, Bind 199, Nr. 2, 06.2023, s. 293-304.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Current clinical practice in the management of phyllodes tumors of the breast
T2 - an international cross-sectional study among surgeons and oncologists
AU - Sars, Carl
AU - Sackey, Helena
AU - Frisell, Jan
AU - Dickman, Paul W.
AU - Karlsson, Fredrik
AU - Kindts, Isabelle
AU - Marta, Gustavo Nader
AU - Freitas-Junior, Ruffo
AU - Tvedskov, Tove Filtenborg
AU - Kassem, Loay
AU - Ali, Ahmed S.
AU - Ihalainen, Hanna
AU - Neron, Mathias
AU - Kontos, Michalis
AU - Kaidar-Person, Orit
AU - Meattini, Icro
AU - Francken, Anne Brecht
AU - van Duijnhoven, Frederieke
AU - Moberg, Ingvild Ona
AU - Marinko, Tanja
AU - Kollar, Attila
AU - Ahmed, Mahbubl
AU - Remoundos, Dennis
AU - Banks, Jenny
AU - Jagsi, Reshma
AU - Dossett, Lesly A.
AU - Lindqvist, Ebba K.
N1 - Funding Information: The authors have no relevant financial or non-financial interests to disclose. Outside the submitted work, RJ has stock options as compensation for her advisory board role in Equity Quotient, a company that evaluates culture in health care companies; she has received personal fees from the Greenwall Foundation, Doris Duke Charitable Foundation, and the National Institutes of Health and grants or contracts for unrelated work from the National Institutes of Health, the Doris Duke Charitable Foundation, the American Cancer Society, the Greenwall Foundation, Genentech, and Blue Cross Blue Shield of Michigan. She has served as an expert witness for Sherinian and Hasso, Dressman Benzinger LaVelle, and Kleinbard, LLC. Publisher Copyright: © 2023, The Author(s).
PY - 2023/6
Y1 - 2023/6
N2 - Purpose: Phyllodes tumors of the breast are rare fibroepithelial lesions that are classified as benign, borderline or malignant. There is little consensus on best practice for the work-up, management, and follow-up of patients with phyllodes tumors of the breast, and evidence-based guidelines are lacking. Methods: We conducted a cross-sectional survey of surgeons and oncologists with the aim to describe current clinical practice in the management of phyllodes tumors. The survey was constructed in REDCap and distributed between July 2021 and February 2022 through international collaborators in sixteen countries across four continents. Results: A total of 419 responses were collected and analyzed. The majority of respondents were experienced and worked in a university hospital. Most agreed to recommend a tumor-free excision margin for benign tumors, increasing margins for borderline and malignant tumors. The multidisciplinary team meeting plays a major role in the treatment plan and follow-up. The vast majority did not consider axillary surgery. There were mixed opinions on adjuvant treatment, with a trend towards more liberal regiments in patients with locally advanced tumors. Most respondents preferred a five-year follow-up period for all phyllodes tumor types. Conclusions: This study shows considerable variation in clinical practice managing phyllodes tumors. This suggests the potential for overtreatment of many patients and the need for education and further research targeting appropriate surgical margins, follow-up time and a multidisciplinary approach. There is a need to develop guidelines that recognize the heterogeneity of phyllodes tumors.
AB - Purpose: Phyllodes tumors of the breast are rare fibroepithelial lesions that are classified as benign, borderline or malignant. There is little consensus on best practice for the work-up, management, and follow-up of patients with phyllodes tumors of the breast, and evidence-based guidelines are lacking. Methods: We conducted a cross-sectional survey of surgeons and oncologists with the aim to describe current clinical practice in the management of phyllodes tumors. The survey was constructed in REDCap and distributed between July 2021 and February 2022 through international collaborators in sixteen countries across four continents. Results: A total of 419 responses were collected and analyzed. The majority of respondents were experienced and worked in a university hospital. Most agreed to recommend a tumor-free excision margin for benign tumors, increasing margins for borderline and malignant tumors. The multidisciplinary team meeting plays a major role in the treatment plan and follow-up. The vast majority did not consider axillary surgery. There were mixed opinions on adjuvant treatment, with a trend towards more liberal regiments in patients with locally advanced tumors. Most respondents preferred a five-year follow-up period for all phyllodes tumor types. Conclusions: This study shows considerable variation in clinical practice managing phyllodes tumors. This suggests the potential for overtreatment of many patients and the need for education and further research targeting appropriate surgical margins, follow-up time and a multidisciplinary approach. There is a need to develop guidelines that recognize the heterogeneity of phyllodes tumors.
KW - Breast neoplasms
KW - Margins of excision
KW - Phyllodes tumor
KW - Surgical oncology
U2 - 10.1007/s10549-023-06896-1
DO - 10.1007/s10549-023-06896-1
M3 - Journal article
C2 - 36879102
AN - SCOPUS:85149419357
VL - 199
SP - 293
EP - 304
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
SN - 0167-6806
IS - 2
ER -
ID: 373037535