乳腺叶状瘤:来自多机构队列的真实世界数据

IF 7.9 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Carl Sars , Jan Frisell , Paul W. Dickman , Felix Haglund de Flon , Fredrik Karlsson , Helena Sackey , Ebba K. Lindqvist
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引用次数: 0

摘要

叶状瘤(PT)是一种罕见的由纤维上皮间质引起的乳腺病变,临床上很难与纤维腺瘤区分。它们被定义为良性、边缘性和恶性。本研究的目的是描述诊断检查和手术处理,并调查局部复发率(LR)和总生存率(OS)与肿瘤亚型、大小、年龄、手术切缘、手术方法和诊断年份的关系。方法回顾性队列研究1999年至2018年在瑞典斯德哥尔摩接受手术治疗的所有PT患者。进行描述性分析,并使用回归模型分析所选协变量与LR和OS之间的关联。结果191例患者中,132例为良性PT, 40例为交界性PT, 19例为恶性PT。术前诊断结果往往不明确,只有45.6%的患者术前诊断为PT, 93.2%的患者初始手术保乳。复发发生率为10.5%。整个队列的5年和10年OS分别为96.1%和93.5%。在多变量分析中,两个协变量都与LR的风险无关。结论在PT的诊治中,常用的诊断方法如FNAC、CNB、乳腺x线摄影等可能不可靠,临床怀疑对指导术前决策起着至关重要的作用。我们发现手术切缘与LR或OS发生率之间没有关联。我们未发现良性或交界性PT有转移潜能的证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Phyllodes tumors of the breast: Real world data from a multi-institution cohort

Introduction

Phyllodes tumors (PT) are rare breast lesions arising from fibroepithelial stroma and may be hard to clinically distinguish from fibroadenomas. They are defined as benign, borderline or malignant. The purpose of this study was to describe diagnostic workup and surgical management, and to investigate incidence of local recurrence (LR) and overall survival (OS) in relation to tumor subtype, size, age, surgical margins, surgical method, and year of diagnosis.

Methods

Retrospective cohort study of all patients surgically treated for a PT in Stockholm, Sweden from 1999 to 2018. Descriptive analyses were performed, and regression models were used to analyze associations between selected covariates and LR and OS.

Results

Among 191 patients, 132 were treated for a benign PT, 40 for a borderline PT and 19 for a malignant PT. Preoperatively, results from diagnostic workup were often ambiguous, and only 45.6 % of cases had a preoperative diagnosis of PT. Initial surgery was breast-conserving in 93.2 % of patients. Recurrences occurred in 10.5 % of the total cohort. 5-year and 10-year OS was 96.1 % and 93.5 %, respectively, for the entire cohort. In a multivariable analysis, neither covariate was associated with risk of LR. Distant recurrences were only detected among patients with malignant PT.

Conclusions

In the workup of PT, common diagnostic methods such as FNAC, CNB, and mammography may be unreliable, and clinical suspicion plays a critical role in guiding pre-operative decision-making. We found no association between surgical margins and rate of LR or OS. We found no evidence of metastatic potential in benign or borderline PT.
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来源期刊
Breast
Breast 医学-妇产科学
CiteScore
8.70
自引率
2.60%
发文量
165
审稿时长
59 days
期刊介绍: The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.
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