Phyllodes Tumor of the Breast: Association Between Age, Surgical Treatment and Survival

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Publication Date

4-26-2020

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Presentation: 38.05

Abstract

Background: Phyllodes tumor of the breast (PT) is a rare malignancy among women worldwide accounting for less than 1% of all primary breast neoplasms (Chao et al., 2019). Little evidence exists describing the survival in PT in younger and older age women. The objective of this study was to evaluate the association of age on initial surgical treatment and outcomes in adults including older age patients with PT of the breast

Methods: A retrospective, cohort study was conducted using data from the Surveillance Epidemiology and End Results Program (SEER) for women ≥18 years old and diagnosed with PT from 1988-2015. The main exposure of interest was age at presentation (18-49 vs. 50-64 vs. ≥65). The main outcomes of interest were initial surgical treatment (breast conserving surgery vs. mastectomy) and survival (OS and CSS). The outcomes were adjusted for race/ethnicity, marital status, time period of diagnosis, tumor grade, tumor size, and initial surgical treatment. Descriptive statistics were used to describe the relationship between age and other demographic/clinical variables. Multivariate logistic regression was used to assess the association of age on initial surgical treatment. Kaplan-Meier analysis was used to estimate overall survival and cause-specific survival estimates. The log-rank test was used to compare survival estimates between age groups. Risk for PT survival at five years we identified using univariate and multivariable Cox analysis.

Results: A total of 2052 women aged ≥18 year and older with PT were identified. The majority of patients were 18-49 years old, white, married, diagnosed between 2006-2015, had an unknown tumor grade, tumor size ≤5cm, and underwent breast conserving surgery (BCS). Roughly 48.2% (n=988) and 51.8% (n=1064) of patients underwent mastectomy and breast conserving surgery (BCS), respectively. Younger aged patients (18-49 years old) with PT (45.0%, n=923) exhibited better (OS;=38.411,pp 5cm exhibited worse (OS;149.83,p ppp.

Conclusion: In this sample of PT patients it was determined that there is significant evidence on the association of survival at five years based on patient age, tumor size and type of initial surgical treatment. These findings have important implications for practice and policy and suggests we need to explore ways of increasing earlier diagnosis among younger and older aged PT patients.

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English

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