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To summarize the evidence on the current management and outcomes for metastatic and recurrent malignant phyllodes tumors (MPTs) of the breast. A systematic literature review of all cases of metastatic or recurrent MPTs of the breast published between 2010 and 2021 was performed. In total, 66 patients from 63 articles were included. Fifty-two (78.8%) had distant metastatic disease (DMD subgroup), and 21 (31.8%) showed locoregional recurrent/progressive disease (LRPR subgroup). Locoregional recurrences in patients with no distant metastases were treated with surgical excision in all cases. Radiotherapy was administered in 8/21 cases (38.1%) and was combined with chemotherapy in 2/21 cases (9.5%). Metastatic disease was managed through metastases surgical excision, chemotherapy, radiotherapy, or a combination of these three in 84.6% of cases, while the remaining patients received no oncological treatments. Chemotherapy was proposed in 75.0% of cases. Anthracycline and alkylating agent-based combination regimens were most frequently administered. The median survival time was 24 (2.0–152.0) months, and 72.0 (2.5–98.5) months in the DMD and LRPR subgroups, respectively. Management of recurrent or metastatic MPTs is challenging. Surgery is the fundamental approach, but the use of adjuvant radio- and chemo-therapy remains controversial due to the lack of scientific evidence. Further studies and international registers are needed to implement new and more efficient treatment strategies.

To summarize the evidence on the current management and outcomes for metastatic and recurrent malignant phyllodes tumors (MPTs) of the breast. A systematic literature review of all cases of metastatic or recurrent MPTs of the breast published between 2010 and 2021 was performed. In total, 66 patients from 63 articles were included. Fifty-two (78.8%) had distant metastatic disease (DMD subgroup), and 21 (31.8%) showed locoregional recurrent/progressive disease (LRPR subgroup). Locoregional recurrences in patients with no distant metastases were treated with surgical excision in all cases. Radiotherapy was administered in 8/21 cases (38.1%) and was combined with chemotherapy in 2/21 cases (9.5%). Metastatic disease was managed through metastases surgical excision, chemotherapy, radiotherapy, or a combination of these three in 84.6% of cases, while the remaining patients received no oncological treatments. Chemotherapy was proposed in 75.0% of cases. Anthracycline and alkylating agent-based combination regimens were most frequently administered. The median survival time was 24 (2.0-152.0) months, and 72.0 (2.5-98.5) months in the DMD and LRPR subgroups, respectively. Management of recurrent or metastatic MPTs is challenging. Surgery is the fundamental approach, but the use of adjuvant radio- and chemo-therapy remains controversial due to the lack of scientific evidence. Further studies and international registers are needed to implement new and more efficient treatment strategies. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prognosis, the patient and tumor characteristics, and the treatment of bilateral breast cancer (BBC) and to compare synchronous (sBBC) and metachronous BBC (mBBC).Materials and Methods: For this retrospective study, data from 123 consecutive BBC patients (56 sBBC and 67 mBBC) that were presented at the Sion Hospital tumor board between 2007 and 2018 were collected retrospectively.Results: Mean follow-up was 85 months. 2nd tumors in both groups were more often diagnosed radiologically. Mean time interval between mBBC was 115 months. A shorter interval was positively correlated with a negative hormonal receptor (HR) status and higher grade for the 2nd tumor. There was no difference in overall survival (OS) and relapse-free survival (RFS) between sBBC and mBBC. OS was longer if both tumors were hormonal receptor (HR) positive. mBBC exhibited a higher local recurrence rate than sBBC (p=0.03).Conclusion: sBBC and mBBC patients did not show any difference in OS or RFS, although mBBC patients were more prone to local relapses.

Objective: To evaluate the prognosis, the patient and tumor characteristics, and the treatment of bilateral breast cancer (BBC) and to compare synchronous (sBBC) and metachronous BBC (mBBC). Materials and Methods: For this retrospective study, data from 123 consecutive BBC patients (56 sBBC and 67 mBBC) that were presented at the Sion Hospital tumor board between 2007 and 2018 were collected retrospectively. Results: Mean follow-up was 85 months. 2nd tumors in both groups were more often diagnosed radiologically. Mean time interval between mBBC was 115 months. A shorter interval was positively correlated with a negative hormonal receptor (HR) status and higher grade for the 2nd tumor. There was no difference in overall survival (OS) and relapse-free survival (RFS) between sBBC and mBBC. OS was longer if both tumors were hormonal receptor (HR) positive. mBBC exhibited a higher local recurrence rate than sBBC (p=0.03). Conclusion: sBBC and mBBC patients did not show any difference in OS or RFS, although mBBC patients were more prone to local relapses. [ABSTRACT FROM AUTHOR]

Objective: It is known fact that locoregional relapse is a significant risk factor for distant metastases. In breast cancer, local or regional relapses are seen between %1-10 in all patients. To search the relationship between the distinct factors in cases with regional relapses (relapse zone, relapse time, pathological features of the tumor etc.) and prognosis of the disease. Materials and Methods: The data of the 30 breast cancer patients, who had a surgery for the disease in our center between 1994-2015 and had a regional lymph node relapse in the follow-up period were included in the study. Clinicopathological features and long term survival data were assessed retrospectively. Results: The median age was 43 (29-74), %37 of the patients were younger than 40 age (n=11), and 19 patients (63%) were premenopausal (n=19). As pathologic stage, 90% of the tumors were TI-II and 10% was TIII-IV, whereas 43% was N0 (n=13), 30% was N1 (n=9), 20% was N2 (n=6) and %7 was N3 (n=2). The most common histological type was invasive ductal ca in 24 patients (n=30), whereas 19 patients had hormor receptor (HR) positivity (70%, n=27), and 5 patients had HER2 positivity (25%, n=20). At a median follow-up of 102 months (17-228), 19 patients had axillary relapse (%63), 7 patients had supraclavicullary relapse (24%) and remaining 4 had relapses in the other regions (13%). Of those, 70% had axillary lymph node dissection (n=21) and %22 had sentinel lymph node biopsy (n=9). Adjuvant radiotheraphy was given to 83% of the patients (n=25). The majority of locoregional recurrences (70%, n=21) were seen with local recurrences following mastectomy or breast conservation, whereas 9 patients had isolated locoregional recuurence. Of 8 patients with axillary recurrences, 5 had SLNB and 3 had axillary lymph node dissection, and almost all of them received radiaiton. The regional relapses were accompanied by distant metastases in 30% of cases. Median relapse time was 33.5 months (6-192). Of the relapses, 43% was seen in the first 24 months (n=13), 27% was seen between 25-60 months (n=8) and 30% was seen after 60 months (n=9). Hormone receptor-negative patients (n=6) were more likely to recur within the first 24 months compared to HR+ patients (n=5) (%75 vs %26%, p=0.033). Of those, 11 patients (38%) had distant organ metastases after the local relapse with a 5-year disease specific survival of 82%, whereas the 5-year disease specific survival after an axillary relapse was 93%. Conclusion: Our results suggest that patients with isolated local regional relapses have excellent prognosis, and the relapses in the HR-patients were usually seen in the first 24 months. Since the majority of patients with isolated locoregional recurrences already received radiation and had a negative pathology for lymph nodes, there may be other biological factors for future investigation. [ABSTRACT FROM AUTHOR]