Treating rare phyllodes tumors of the breast with radiation therapy may lower recurrence rate
Patients with rare phyllodes tumors of the breast may
benefit from receiving radiation therapy in addition to surgery to prevent recurrence,
according to a study in the July issue of the International Journal of Radiation
Oncology*Biology*Physics, the journal of the American Society for Therapeutic
Radiology and Oncology.
Phyllodes tumors are rare breast tumors that develop
in the connective tissue of the breast, as opposed to more common carcinomas,
which develop in the ducts or lobules of the breast. Most patients are treated
for phyllodes tumors with either a lumpectomy or mastectomy, with only a small
fraction of patients receiving radiation therapy. Traditionally, adjuvant radiation
therapy is recommended for cancer patients with local recurrence risks of 15 percent
or greater, but the value of adjuvant radiation therapy has not been extensively
studied for phyllodes tumors because they are so rare.
Researchers at the Division of Radiation Oncology, Department
of Medical Physics, and Department of General and Oncologic Surgery at City of
Hope National Medical Center in Duarte, Calif., sought to determine the local
recurrence rates of phyllodes tumors based on tumor size and the type of surgery
performed and whether adjuvant radiation therapy should be considered as a treatment
for some phyllodes tumor patients to reduce their local recurrence rate.
"Typically these tumors are treated well by surgery alone.
However, local recurrences are not uncommon," Richard Pezner, M.D., lead author
of the study and a radiation oncologist at City of Hope National Medical Center
in Duarte, Calif., said.
The study authors reviewed records of 478 patients with
malignant phyllodes tumors who were treated between March 1964 and August 2005.
The records came from the IMPAC National Oncology Database, which consists of
tumor registries from 130 hospitals.
The researchers found that the risk of local recurrence
for phyllodes tumors was related to tumor size and the type of surgery received.
They determined that adjuvant radiation therapy should be evaluated for phyllodes
tumor patients who received lumpectomies for tumors at least 2 centimeters in
size or a mastectomy for tumors at least 10 centimeters in size to reduce the
risk of recurrence.
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