유방 엽상종의 임상병리학적 양상에 따른 국소 재발의 위험 인자들

다국어 초록 (Multilingual Abstract)

Purpose: Phyllodes tumor is a rare fibroepithelial disease of the breast that is classified as benign, borderline malignant, or malignant according to the pathological characteristics. To clarify diagnostic criteria for these groups, we analyzed the clinico-pathological characteristics of phyllodes tumors and the risk factors for local recurrence after surgery.
Methods: Between January 1997 and March 2003, we included 70 cases of recurring, pathologically-confirmed phyllodes tumors after surgery. Medical records were reviewed retrospectively for clinical characteristics and pathologic findings.
Results: The mean follow up period was 69.3 months (range 45.4 to 119.3 months) and mean age, 39.4 years old (range 18 to 63 years old). Benign phyllodes tumors were present in 45 cases (64.3%), borderline malignant tumors in 15 cases (21.4%), and malignant tumors in 10 cases (14.3%). A local recurrence developed in 9 cases (12.9%), with three of these cases benign (33.3%), 5 cases were borderline malignant (55.6%), and 1 case was malignant (11.1%). Borderline malignant cases showed a higher local recurrent rate (6.7%, 33.3%, and 10.0%, P=0.027). The local recurrence rate between the tumor-positive or close (＜1 ㎜) resection margins and non-involved cases was different for benign (7.7% vs. 6.3%, P=0.031) and borderline malignant cases (60.0% vs. 20.0%, ns).
Conclusion: Pathologic classification and small resection margins are risk factors for local recurrence in phyllodes tumors. Therefore, borderline malignant phyllodes tumors require wide excision with a sufficient resection margin or a mastectomy to prevent local recurrence.

목차 (Table of Contents)

• 서론
• 방법
• 결과
• 고찰
• 결론
• REFERENCES

참고문헌 (Reference)

1 Kim HJ, 58 : 352-360, 2000

2 Zurrida S, "Which therapy for unexpected phyllodes tumor of the breast?" 28 : 654-657, 1992

3 Cole-Beuglet C, "Ultrasound, X-ray mammography and histopathology of cystosarcoma phyllodes" 146 : 8-, 1983

4 Palmer ML, "Treatment options andrecurrence potential for cystosarcoma phyllodes" 170 : 193-196, 1990

5 Ozzello L, "The management of patients with carcinomas in fibroadenomatous tumors of the breast" 146 : 358-, 1978

6 Bruno S, "Surgical treatment of phyllodes tumors of the breast" 63 : 2532-2536, 1989

7 Norris HJ, "Relationship of histologic features to behavior ofcystosarcoma phyllodes" 20 : 2090-2099, 1967

8 Lindquist KD, "Recurrent andmetastatic cystosarcoma phyllodes" 144 : 341-343, 1982

9 Cohn-Cedermark G, "Prognostic factors in cystosarcoma phyllodes: a clinicopathologic study of 77 patients" 68 : 2017-2022, 1991

10 Pick PW, "Occurrence of breast carcinoma within afibroadenoma: a review" 108 : 590-594, 1984

11 Kessinger A, "Metastatic cystosarcomaphyllodes: a case report and review of the literature" 4 : 131-147, 1972

12 Browder W, "Malignant cystosarcoma phyllodes" 136 : 239-, 1978

13 Hawkins RE, "Ifosfamide is an active drug for chemotherapy of metastatic cystosarcoma phyllodes" 69 : 2271-2275, 1992

14 Barth RJ Jr, "Histologic features predict local recurrence after breast conserving therapy of phyllodes tumors" 57 : 291-295, 1999

15 Lee BJ, "Giant intracanalicular fibroadenomyxoma of the breast. The so-called cystosarcoma phyllodes mammae of Johannes Meuller" 15 : 2583-, 1931

16 Ward RM, "Cystosarcoma phyllodes; a clinocopathological study of 26 cases" 58 : 2282-2289, 1986

17 Vorherr H, "Cystosarcoma phyllodes: epidemiology, pathohistology, pathobiology, diagnosis, therapy and survival" 236 : 173-181, 1985

18 Burton GV, "Cystosarcoma phyllodes: effective therapy with cisplatin and etoposidechemotherapy" 63 : 2088-2092, 1989

19 Pietruszka M, "Cystosarcoma phyllodes. A clinicopathological analysis of 42 cases" 41 : 1974-1983, 1978

20 Keserson GHD, "Cystosarcoma phyllodes, a steroid receptor andultrastructure analysis" 19 : 640-647, 1979

21 Briggs RM, "Cystosarcoma phyllodes inadolescent female patient" 143 : 712-714, 1983

22 Liberman L, "Benign and malignant phyllodes tumors: mammographic andsonographic findings" 198 : 121-124, 1996