What is the Appropriate Margin Width for a Malignant Phyllodes Tumor

👉Malignant phyllodes tumors carry a high risk of local recurrence if not excised to wide negative margins.

👉How wide these margins should be is a matter of debate with data supporting a negative margin of any width to a negative margin as wide as 2 cm.

👉Currently, the National Comprehensive Cancer Network recommends a margin width of 1cm; however, recent studies suggest margin width is not associated with local recurrence or local recurrence free survival.

👉The addition of radiation therapy when margins are closer than 1 cm or other high-risk features are present can also be a consideration but it is controversial.

👉Most data indicate unacceptably high recurrence rates if the tumor is at the inked margin of a malignant phyllodes tumor excision.

👉Mastectomy is not required unless excision cannot achieve tumor-free margins.

👉The most appropriate margin thickness for borderline or benign phyllodes tumors is even less well-defined.

👉Although achieving widely negative margins can reduce local recurrence rates, malignant phyllodes tumors also have metastatic potential regardless of negative margin status. 

👉REFERENCES

  1. BelkacĂ©mi Y, Bousquet G, Marsiglia H, et al. Phyllodes tumor of the breast. Int J Radiat Oncol Biol Phys. 2008;70:492-500.
  2. 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;19:2612-2617. 
  3. MituĹ› J, Reinfuss M, MituĹ› JW, et al. Malignant phyllodes tumor of the breast: treatment and prognosis. Breast J.2014;20:639-644. 
  4. Petrek J. Phyllodes tumors. In: Harris JR, Lippman ME, Morrow M, et al. eds. Diseases of the Breast, 2nd ed. Philadelphia PA: Lippincott-Raven Publishers, 2000:669-675.
  5. Telli ML, Horst KC, Guardino AE, et al. Phyllodes tumors of the breast: natural history, diagnosis, and treatment. J Natl Compr Canc Netw. 2007;5:324-330. 
  6. Yom CK, Han W, Kim SW, et al. Reappraisal of conventional risk stratification for local recurrence based on clinical outcomes in 285 resected phyllodes tumors of the breast. Ann Surg Oncol. 2015;22:2912-2918.

👉Rodrigo Arrangoiz MS, MD, FACS cirujano oncology y cirujano de mamá de Sociedad QuirĂşrgica S.C en el America British Cowdray Medical Center en la ciudad de Mexico:

  • Es experto en el manejo del cáncer de mama.

 

👉Es miembro de la American Society of Breast Surgeons:

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

 

#Arrangoiz

#Surgeon

#Cirujano

#SurgicalOncologist

#CirujanoOncologo

#BreastSurgeon

#CirujanodeMama

#CancerSurgeon

#CirujanodeCancer

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