Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Malignant phyllodes tumor and primary breast sarcoma; distinct rare tumors of the breast.

Publication ,  Conference
Gutnik, L; Ren, Y; Thomas, SM; Plichta, JK; Greenup, RA; Fayanju, OM; Hwang, ES; Rosenberger, LH
Published in: J Surg Oncol
May 2022

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.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

May 2022

Volume

125

Issue

6

Start / End Page

947 / 957

Location

United States

Related Subject Headings

  • Phyllodes Tumor
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Mastectomy, Segmental
  • Mastectomy
  • Margins of Excision
  • Humans
  • Female
  • Breast Neoplasms
  • Breast
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gutnik, L., Ren, Y., Thomas, S. M., Plichta, J. K., Greenup, R. A., Fayanju, O. M., … Rosenberger, L. H. (2022). Malignant phyllodes tumor and primary breast sarcoma; distinct rare tumors of the breast. In J Surg Oncol (Vol. 125, pp. 947–957). United States. https://doi.org/10.1002/jso.26820
Gutnik, Lily, Yi Ren, Samantha M. Thomas, Jennifer K. Plichta, Rachel A. Greenup, Oluwadamilola M. Fayanju, E Shelley Hwang, and Laura H. Rosenberger. “Malignant phyllodes tumor and primary breast sarcoma; distinct rare tumors of the breast.” In J Surg Oncol, 125:947–57, 2022. https://doi.org/10.1002/jso.26820.
Gutnik L, Ren Y, Thomas SM, Plichta JK, Greenup RA, Fayanju OM, et al. Malignant phyllodes tumor and primary breast sarcoma; distinct rare tumors of the breast. In: J Surg Oncol. 2022. p. 947–57.
Gutnik, Lily, et al. “Malignant phyllodes tumor and primary breast sarcoma; distinct rare tumors of the breast.J Surg Oncol, vol. 125, no. 6, 2022, pp. 947–57. Pubmed, doi:10.1002/jso.26820.
Gutnik L, Ren Y, Thomas SM, Plichta JK, Greenup RA, Fayanju OM, Hwang ES, Rosenberger LH. Malignant phyllodes tumor and primary breast sarcoma; distinct rare tumors of the breast. J Surg Oncol. 2022. p. 947–957.
Journal cover image

Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

May 2022

Volume

125

Issue

6

Start / End Page

947 / 957

Location

United States

Related Subject Headings

  • Phyllodes Tumor
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Mastectomy, Segmental
  • Mastectomy
  • Margins of Excision
  • Humans
  • Female
  • Breast Neoplasms
  • Breast