Goodwin Brandon, Oyinlola Adejumoke Fisayo, Palhang Meejan, Lehman Danielle, Platoff Rebecca, Atabek Umur, Spitz Francis, Hong Young
Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
Cooper Medical School of Rowan University, Camden, NJ, USA.
Am Surg. 2023 Dec;89(12):6190-6196. doi: 10.1177/00031348231198114. Epub 2023 Aug 23.
Metastatic, malignant phyllodes tumor (PT) of the breast is a rare and aggressive neoplasm. Currently, there is no agreed upon consensus as to best management practices. A systematic review of literature was conducted investigating surgical, chemotherapeutic, and radiotherapeutic management for metastatic PT. Databases employed to identify articles included Embase, PubMed, and SAGE Journals. Diagnosis of metastatic PT has been of significant difficulty to radiologists as it is often confused with fibroadenomas. Surgically, metastatectomy has been correlated with increased overall survival (of 25.9 versus 9.9 months; = .01). Radiotherapy has often been associated with palliation and pain control in metastatic, malignant neoplasia. However, one study showed that in malignant PT, radiation was associated with significantly lower rates of local recurrence (OR: 0.048 versus 0.209). Anthracycline containing chemotherapy regimens has been associated with improved overall survival (22.4 months versus 13.2 months; = .040). Further research must be conducted into this rare malignancy to elucidate accurate diagnosis and care for patients with advanced metastatic or malignant phyllodes tumors.
转移性乳腺恶性叶状肿瘤（PT）是一种罕见且侵袭性强的肿瘤。目前，对于最佳治疗方案尚无共识。我们进行了一项文献系统综述，研究转移性PT的手术、化疗和放疗管理。用于识别文章的数据库包括Embase、PubMed和SAGE期刊。转移性PT的诊断对放射科医生来说有很大困难，因为它常与纤维腺瘤混淆。在手术方面，转移灶切除术与总体生存率提高相关（25.9个月对9.9个月；P = 0.01）。放疗在转移性恶性肿瘤中常与姑息治疗和疼痛控制相关。然而，一项研究表明，在恶性PT中，放疗与局部复发率显著降低相关（比值比：0.048对0.209）。含蒽环类药物的化疗方案与总体生存率提高相关（22.4个月对13.2个月；P = 0.040）。必须对这种罕见的恶性肿瘤进行进一步研究，以阐明晚期转移性或恶性叶状肿瘤患者的准确诊断和治疗。
