BACKGROUND: Cystosarcoma phyllodes is a rare sarcoma
of the breast. Although surgical removal is the mainstay of treatment,
the extent of surgery required (excision vs. mastectomy) and
the need for additional local therapy, such as radiotherapy,
are unclear. The current study evaluated the rate of local and
distant failure, as well as potential prognostic factors, to
better define appropriate treatment strategies.
CONCLUSIONS: Local failure in this group of largely margin negative
patients with cystosarcoma phyllodes of the breast was low, showing
that breast-conserving surgery with appropriate margins is the
preferred primary therapy. The current study data do not support
the use of adjuvant radiotherapy for patients with adequately resected
disease. Patients with stromal overgrowth, particularly when the tumor
size was > 5 cm, were found to have a high rate of distant failure; such
patients merit consideration of a trial that examines the efficacy
of systemic therapy.
Am J Surgery, 10/03
NOTE: Surgery only reliable therapy
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