Titre
Width of margins in phyllodes tumors of the breast: the controversy drags on?-a systematic review and meta-analysis.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Toussaint, A.
Auteure/Auteur
Piaget-Rossel, R.
Auteure/Auteur
Stormacq, C.
Auteure/Auteur
Mathevet, P.
Auteure/Auteur
Lepigeon, K.
Auteure/Auteur
Taffé, P.
Auteure/Auteur
Liens vers les personnes
Taffé, Patrick
Mathevet, Patrice
Piaget-Rossel, Romain
Stormacq, Coraline
Liens vers les unités
PMU/UNISANTE
Activités direction commune GYN-OBS
ISSN
1573-7217
Statut éditorial
Date de publication
2021-01
Volume
185
Numéro
1
Première page
21
Dernière page/numéro d’article
37
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Meta-Analysis ; Review ; Systematic Review
Publication Status: ppublish
Publication Status: ppublish
Résumé
Phyllodes tumors (PT) of the breast are rare fibroepithelial neoplasms. Information is controversial in the literature regarding to the optimal surgical management. Most studies suggested margins of at least 10 mm while some recent studies suggested narrower margins without an increased risk of local recurrences (LR) and distant metastases (DM). The objective of this systematic review was to identify and compare studies that assessed these different practices.
A systematic review was performed through five databases up to April 2019. Studies exploring the association between the width of margins, subtypes of PT, and the LR and DM rates were considered for inclusion. A statistical model for analyzing sparse data and rare events was used.
Thirteen studies met eligibility criteria and were selected. Considering a threshold of 10 mm (margins < 10 vs margins ≥ 10 mm), the 5-year incidence rate of LR was estimated to be 5.22 vs. 3.63 (diff. -1.59) per 100 person-years for benign PT, 9.60 vs. 7.33 (diff. -2.27) for borderline PT, and 28.58 vs. 21.84 (diff. -6.74) for malignant PT. For DM, it was estimated to be 0.88 vs. 0.86 (diff. -0.02) for benign PT, 1.61 vs. 1.74 (diff. 0.13) for borderline PT, and 4.80 vs 5.18 (diff. 0.38) for malignant PT. The data for a threshold of 1 mm were not sufficient to draw any conclusions.
Irrespective of tumor grade, we found that DM was a rarer event than LR. Malignant PT had the highest incidence rate of LR and DM. This meta-analysis found a clear association between width of margins and LR rates. Whatever the tumor grade, surgical margins ≥ 10 mm guaranteed a lower risk of LR than margins < 10 mm. On the other hand, the width of margin did not influence the apparition of DM.
A systematic review was performed through five databases up to April 2019. Studies exploring the association between the width of margins, subtypes of PT, and the LR and DM rates were considered for inclusion. A statistical model for analyzing sparse data and rare events was used.
Thirteen studies met eligibility criteria and were selected. Considering a threshold of 10 mm (margins < 10 vs margins ≥ 10 mm), the 5-year incidence rate of LR was estimated to be 5.22 vs. 3.63 (diff. -1.59) per 100 person-years for benign PT, 9.60 vs. 7.33 (diff. -2.27) for borderline PT, and 28.58 vs. 21.84 (diff. -6.74) for malignant PT. For DM, it was estimated to be 0.88 vs. 0.86 (diff. -0.02) for benign PT, 1.61 vs. 1.74 (diff. 0.13) for borderline PT, and 4.80 vs 5.18 (diff. 0.38) for malignant PT. The data for a threshold of 1 mm were not sufficient to draw any conclusions.
Irrespective of tumor grade, we found that DM was a rarer event than LR. Malignant PT had the highest incidence rate of LR and DM. This meta-analysis found a clear association between width of margins and LR rates. Whatever the tumor grade, surgical margins ≥ 10 mm guaranteed a lower risk of LR than margins < 10 mm. On the other hand, the width of margin did not influence the apparition of DM.
PID Serval
serval:BIB_39B8EE12F418
PMID
Date de création
2020-09-19T10:40:45.002Z
Date de création dans IRIS
2025-05-20T18:19:48Z
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Nom
Width of Margins in Phyllodes Tumors of the Breast the Controversy Drags on – A systematic review.pdf
Version du manuscrit
preprint
Taille
1.37 MB
Format
Adobe PDF
PID Serval
serval:BIB_39B8EE12F418.P002
Somme de contrôle
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