Malignant phyllodes tumor and primary breast sarcoma; distinct rare tumors of the breast.
J Surg Oncol
; 125(6): 947-957, 2022 May.
Article
em En
| MEDLINE
| ID: mdl-35179788
ABSTRACT
BACKGROUND:
Malignant phyllodes (MP) and primary breast sarcomas (PBS) are rare neoplasms with overlapping histopathologic features. We compared overall survival (OS) and estimated the association of surgery and therapies with OS.METHODS:
We utilized the National Cancer Database (2004-2016). Patients without surgery, unknown surgery, or margins, or Stage IV disease were excluded. Kaplan-Meier curves and Cox proportional hazards models were used to estimate unadjusted and adjusted OS, respectively.RESULTS:
A total of 3209 (59.5%) MP, and 2185 (40.5%) PBS were identified. Despite a larger median tumor size in MP (46 vs. 40 mm PBS, p < 0.001), lumpectomy rate was higher for MP (52.9% vs. 27.0% PBS, p < 0.001). Compared to MP, PBS patients more frequently received radiation (28.9% vs. 24%), and chemotherapy (28.1% vs. 4%), both p < 0.001. Unadjusted OS was lower for PBS (57% vs. 85% MP, log-rank p < 0.001). PBS (vs. MP) had persistently worse survival (hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.69-2.31) after adjustment. Receipt of adjuvant therapies was not associated with OS (either neoplasm); however, lumpectomy was associated with improved OS (vs. mastectomy) for both PBS (HR 0.59, 95% CI 0.50-0.75) and MP (HR 0.65, 95% CI 0.53-0.81). Positive margins had no association with OS for MP (HR 1.09, 95% CI 0.75-1.60), but was associated with worse survival for PBS (HR 2.35, 95% CI 1.82-3.02).DISCUSSION:
We found significant survival differences between MP and PBS, with PBS having a consistently worse OS. Our findings support surgery as the mainstay of treatment for both tumor types and suggest that lumpectomy may be a reasonable option for select patients without compromising outcomes.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Neoplasias da Mama
/
Tumor Filoide
Tipo de estudo:
Prognostic_studies
Limite:
Female
/
Humans
Idioma:
En
Revista:
J Surg Oncol
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos