Does surgical margin status truly affect local recurrence in benign and borderline phyllodes tumors of the breast?
European Journal of Surgical Oncology, cilt.51, sa.9, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 51 Sayı: 9
- Basım Tarihi: 2025
- Doi Numarası: 10.1016/j.ejso.2025.110195
- Dergi Adı: European Journal of Surgical Oncology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Local recurrence, Phyllodes tumor, Surgical margin, Wide local excision
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Phyllodes tumors of the breast are rare and classified into three groups—benign, borderline, and malignant—based on their malignant potential. Surgical resection is the primary treatment modality; however, the necessity of clear surgical margins remains a topic of debate in the literature. This study aimed to evaluate the relationship between surgical margin status and local recurrence in benign and borderline phyllodes tumors. Methods: A total of 177 patients diagnosed with phyllodes tumors from two centers were included. Patients were analyzed based on demographic, clinical, pathological, and survival data. Results: The median age was 38 years (range: 15–78), and all patients were female. The most commonly performed breast surgery was wide local excision in 173 patients (97.7 %). Final pathological examination revealed that 136 patients (76.8 %) had benign phyllodes tumors, while 41 patients (23.2 %) had borderline phyllodes tumors. The median pathological tumor diameter was 35 mm (IQR: 27–55 mm). During a median follow-up of 60 months, local recurrence occurred in 12 patients (6.8 %), while no systemic metastasis or tumor-related death was observed. Patients with borderline phyllodes tumors had a higher local recurrence rate and shorter recurrence-free survival (RFS) (p = 0.022 and p = 0.013, respectively). Cox regression analysis identified tumor type as the only independent factor affecting RFS, with borderline phyllodes tumors demonstrating a shorter RFS compared to benign phyllodes tumors (p = 0.015). Conclusion: Surgical margin status was not associated with local recurrence in benign and borderline phyllodes tumors. Therefore, re-excision decisions based on margin proximity or positivity should be individualized.