National surgical patterns of care for primary surgery and axillary staging of phyllodes tumors.
Phyllodes tumors (PT) are rare and unique in their suspected stromal and epithelial origin, and their propensity to recur despite surgical resection. Current surgical treatment of PT does not include sampling of regional lymph nodes (LNs) as malignant PT infrequently spread to LNs. We hypothesize th...
| Publicado en: | Breast Journal Vol. 15; no. 1; pp. 41 - 45 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jan/Feb2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105614916&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105614916 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1075122X ET6 jtl: Breast Journal issn: 1075122X maglogo: Y pubinfo: dt: Jan/Feb2009 vid: 15 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105614916 2010154127 10.1111/j.1524-4741.2008.00669.x NLM19141133 105614916 ppf: 41 ppct: 4 formats: fmt: @attributes: type: P tig: atl: National surgical patterns of care for primary surgery and axillary staging of phyllodes tumors. aug: au: Gullett NP Rizzo M Johnstone PAS affil: Department of Radiation Oncology, Emory University School of Medicine, 1365 Clifton Rd NE, Atlanta, GA 30322 sug: subj: Axilla Pathology Lymph Nodes Surgery Neoplasms Surgery Adolescence Adult Aged Aged, 80 and Over Child Descriptive Statistics Female Middle Age P-Value Human Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Aged, 80 & over Child: 6-12 years Middle Aged: 45-64 years Female ab: Phyllodes tumors (PT) are rare and unique in their suspected stromal and epithelial origin, and their propensity to recur despite surgical resection. Current surgical treatment of PT does not include sampling of regional lymph nodes (LNs) as malignant PT infrequently spread to LNs. We hypothesize that, because of substantial experience with common epithelial lesions of the breast, surgeons are more prone to sample LNs in PT patients. We reviewed national surgical patterns of care of axillary LN sampling for PT using the Surveillance Epidemiology & End Results (SEER) registry. SEER data for LN evaluation are available from 1988. The public-access SEER data-base was queried for patients presenting over all 17 registries between 1988 and 2003 with PT of the breast. Data were collated by type of surgery and number of LNs examined, and further analyzed by tumor size of the primary lesion where available; 1,035 cases of PT were identified for the 16-year period. Patients had a median age of 50 (range 12-96). Of the specimens with SEER grade listed, 117 were well-differentiated, 186 moderately differentiated, 79 poorly differentiated, and 132 undifferentiated; 612 (59.1%) cases had specific surgical procedures reported: 191 partial, 251 simple, 5 subcutaneous, 154 modified radical, and 6 radical mastectomies, with 5 mastectomies (NOS) documented. The remainder of cases had surgery that was coded as 'undocumented' or unknown. When surveyed by LNs examined, 25.5% of patients ( n = 264) underwent some degree of regional lymphadenectomy; the median number of LNs examined in these patients was 7 (range 1-37). Of all PT patients, 9.0% of patients underwent axillary sampling of 10 LN or more. Only nine patients (3.4%) had positive LNs. When assessing axillary sampling rate by tumor size, smaller lesions were less likely to undergo sampling than larger lesions (19.3% for lesions <2 cm, 20.5% for lesions 2-4.9 cm, 27.9% for 5-9.9 cm); although this was nonsignificant. In spite of the lack of supporting data for LN examination axillary staging continues to be performed for many cases of PT. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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