Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins.
J Clin Pathol
; 65(1): 69-76, 2012 Jan.
Article
en En
| MEDLINE
| ID: mdl-22049216
ABSTRACT
AIM:
To define a predictive model for clinical behaviour of breast phyllodes tumours (PT) using histological parameters and surgical margin status.METHODS:
Cases of breast PT diagnosed in the Department of Pathology Singapore General Hospital between January 1992 and December 2010 were stratified into benign, borderline and malignant grades based on a combination of histological parameters (stromal atypia, hypercellularity, mitoses, overgrowth and nature of tumour borders). Surgical margin status was assessed. Clinical follow-up and biostatistical modelling were accomplished.RESULTS:
Of 605 PT, 440 (72.7%) were benign, 111 (18.4%) borderline and 54 (8.9%) malignant. Recurrences, which were predominantly local, were documented in 80 (13.2%) women. Deaths from PT occurred in 12 (2%) women. Multivariate analysis revealed stromal atypia, overgrowth and surgical margins to be independently predictive of clinical behaviour, with mitoses achieving near significance. Stromal hypercellularity and tumour borders were not independently useful. A nomogram developed based on atypia, mitoses, overgrowth and surgical margins (AMOS criteria) could predict recurrence-free survival at 1, 3, 5 and 10 years. This nomogram was superior to a total histological score derived from adding values assigned to each of five histological parameters.CONCLUSION:
A predictive nomogram based on three histological criteria and surgical margin status can be used to calculate recurrence-free survival of an individual woman diagnosed with PT. This can be applied for patient counselling and clinical management.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
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Tumor Filoide
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Nomogramas
/
Mastectomía
/
Modelos Biológicos
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
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Risk_factors_studies
País/Región como asunto:
Asia
Idioma:
En
Año:
2012
Tipo del documento:
Article