1
|
DALCI K, GUL MO, SARITAŞ AG, GÜMÜŞ S, SAKMAN G, ERGİN M. Memenin filloides tümörlerinin klinik özellikleri ve süreci. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.738184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
2
|
Stoffel E, Becker AS, Wurnig MC, Marcon M, Ghafoor S, Berger N, Boss A. Distinction between phyllodes tumor and fibroadenoma in breast ultrasound using deep learning image analysis. Eur J Radiol Open 2018; 5:165-170. [PMID: 30258856 PMCID: PMC6154513 DOI: 10.1016/j.ejro.2018.09.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 09/07/2018] [Accepted: 09/07/2018] [Indexed: 01/16/2023] Open
Abstract
Purpose To evaluate the accuracy of a deep learning software (DLS) in the discrimination between phyllodes tumors (PT) and fibroadenomas (FA). Methods In this IRB-approved, retrospective, single-center study, we collected all ultrasound images of histologically secured PT (n = 11, 36 images) and a random control group with FA (n = 15, 50 images). The images were analyzed with a DLS designed for industrial grade image analysis, with 33 images withheld from training for validation purposes. The lesions were also interpreted by four radiologists. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC). Sensitivity, specificity, negative and positive predictive values were calculated at the optimal cut-off (Youden Index). Results The DLS was able to differentiate between PT and FA with good diagnostic accuracy (AUC = 0.73) and high negative predictive value (NPV = 100%). Radiologists showed comparable accuracy (AUC 0.60–0.77) at lower NPV (64–80%). When performing the readout together with the DLS recommendation, the radiologist’s accuracy showed a non-significant tendency to improve (AUC 0.75–0.87, p = 0.07). Conclusion Deep learning based image analysis may be able to exclude PT with a high negative predictive value. Integration into the clinical workflow may enable radiologists to more confidently exclude PT, thereby reducing the number of unnecessary biopsies.
Collapse
Affiliation(s)
- Elina Stoffel
- Institute for Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
| | - Anton S Becker
- Institute for Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
| | - Moritz C Wurnig
- Institute for Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
| | - Magda Marcon
- Institute for Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
| | - Soleen Ghafoor
- Institute for Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
| | - Nicole Berger
- Institute for Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
| | - Andreas Boss
- Institute for Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
| |
Collapse
|
3
|
Can problematic fibroepithelial lesions be accurately classified on core needle biopsies? Hum Pathol 2016; 47:38-44. [DOI: 10.1016/j.humpath.2015.09.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 08/21/2015] [Accepted: 09/02/2015] [Indexed: 11/16/2022]
|
4
|
Gnerlich JL, Williams RT, Yao K, Jaskowiak N, Kulkarni SA. Utilization of radiotherapy for malignant phyllodes tumors: analysis of the National Cancer Data Base, 1998-2009. Ann Surg Oncol 2013; 21:1222-30. [PMID: 24306659 DOI: 10.1245/s10434-013-3395-6] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Malignant phyllodes tumors of the breast have traditionally been treated with surgical excision. Recently, the use of adjuvant radiotherapy has been advocated to reduce the risk of local recurrence; however, this recommendation is controversial in the absence of consistent outcome data. We hypothesize that there has been a trend toward increased utilization of adjuvant radiotherapy for malignant phyllodes tumors despite its uncertain effect on outcomes. METHODS Using the National Cancer Data Base, predictors of radiotherapy utilization were examined for women with malignant phyllodes from 1998 to 2009. Kaplan-Meier and Cox regression models were generated to determine the effect of radiotherapy on local recurrence (LR), disease-free survival (DFS), and overall survival (OS). RESULTS Of the 3,120 patients with malignant phyllodes, 57 % underwent breast conservation surgery and 42 % underwent mastectomy. Overall, 14.3 % of women received adjuvant radiotherapy. Utilization of radiotherapy doubled over the study period (9.5 % in 1998-1999 vs. 19.5 % in 2008-2009, p < 0.001). Women were significantly more likely to receive radiotherapy if they were diagnosed later in the study, were age 50-59 years old, had tumors >10 cm, or had lymph nodes removed. For the 1,774 patients with available recurrence data, overall recurrence was 14.1 %, and LR was 5.9 %. In adjusted models, adjuvant radiotherapy reduced LR (aHR 0.43, 95 % CI 0.19-0.95) but did not impact DFS or OS after 53 months' median follow-up. CONCLUSIONS Utilization of adjuvant radiotherapy for malignant phyllodes doubled from 1998 to 2009. Radiotherapy significantly reduced LR but had no effect on DFS or OS.
Collapse
Affiliation(s)
- Jennifer L Gnerlich
- Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA
| | | | | | | | | |
Collapse
|
5
|
Spitaleri G, Toesca A, Botteri E, Bottiglieri L, Rotmensz N, Boselli S, Sangalli C, Catania C, Toffalorio F, Noberasco C, Delmonte A, Luini A, Veronesi P, Colleoni M, Viale G, Zurrida S, Goldhirsch A, Veronesi U, De Pas T. Breast phyllodes tumor: A review of literature and a single center retrospective series analysis. Crit Rev Oncol Hematol 2013; 88:427-36. [DOI: 10.1016/j.critrevonc.2013.06.005] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 05/03/2013] [Accepted: 06/12/2013] [Indexed: 11/12/2022] Open
|
6
|
Sawalhi S, Al-Shatti M. Phyllodes tumor of the breast: a retrospective study of the impact of histopathological factors in local recurrence and distant metastasis. Ann Saudi Med 2013; 33:162-8. [PMID: 23563006 PMCID: PMC6078618 DOI: 10.5144/0256-4947.2013.162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The challenging issue for the breast surgeons is local recurrence of phyllodes tumor. The histological criteria to predict local recurrence has been a controversial issue. The objective of this study was to determine pathological parameters and surgical margins that influence outcome of local recurrence and distant metastasis in phyllodes tumor (PT). DESIGN AND SETTING Retrospective review between January 2003 to August 2008 at King Hussein Cancer Center-Jordan. PATIENTS AND METHODS Forty-two female patients diagnosed as having PT were classified to benign, borderline and malignant. The medical records were reviewed in relation to the surgical management, recurrence, follow-up, the histological features of the tumor and grading of tumors based on the following histological parameters: mitotic count, stromal cellularity, stromal overgrowth, cellular pleomorphism, nuclear grade, tumor necrosis, tumor margin, and surgical margin status. All patients underwent wide local excision of the tumor or mastectomy. RESULTS Forty-two patients with PT (16 benign, 9 borderline, 17 malignant PT) were followed up for 30 months. The mean age was 39.8 years, and the average tumor size was 6.6 cm. The recurrence rate of PT in our study was 21% at a mean time of 11 months. Nine patients had local recurrence; 2 benign, 6 malignant and 1 borderline. Cellular pleomorphism had correlation with recurrence rate (P=.045). We had six patients (14%) with distant metastasis. All had malignant PT. Metastasis in PT has a relationship with histological grade (P=.02). CONCLUSIONS We conclude that patients with moderate and severe cellular pleomorphism had higher local recurrence, while metastatic PT occur more in patients with high nuclear grade.
Collapse
Affiliation(s)
- Samer Sawalhi
- Department of Surgery- College of Medicine, Taibah University, Al-Madinah 30001, Saudi Arabia.
| | | |
Collapse
|
7
|
Jayasinghe Y, Simmons PS. Occurrence of two rare malignant neoplasms (breast and ovarian) in an adolescent female. J Pediatr Adolesc Gynecol 2009; 22:e99-103. [PMID: 19493515 DOI: 10.1016/j.jpag.2006.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Revised: 11/15/2006] [Accepted: 11/16/2006] [Indexed: 12/28/2022]
Abstract
BACKGROUND Phyllodes breast tumors, particularly malignant ones, are rare in adolescents. Tumor behavior does not correlate with histopathology. This case of an adolescent with a malignant phyllodes tumor, followed by the occurrence of a borderline ovarian tumor, also uncommon in adolescence, may shed light on our understanding of phyllodes and uncommon gynecologic malignancies in the young. CASE A-14 year-old Caucasian female underwent wide local excision of a 4-cm malignant phyllodes breast tumor. At 17 years of age she had excision of a serous borderline tumor of the ovary. COMMENTS The occurrence of two rare neoplasms in an adolescent female raises questions about a common underlying etiology, such as a genetic mutation. Genetic evaluation of minors is a sensitive and complex issue. Natural history studies regarding phyllodes tumors presenting in adolescence are needed to establish recommendations regarding best practice, including the role of genetic evaluation in this population.
Collapse
Affiliation(s)
- Yasmin Jayasinghe
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
| | | |
Collapse
|
8
|
Kobayashi T, Asakawa H, Fukuda H, Andachi H, Komoike Y, Nakano Y, Tamaki Y, Monden M. Histologic examination of two cases of cystosarcoma phylloaes with pulmonary metastases. Breast Cancer 2008; 5:301-7. [PMID: 18841337 DOI: 10.1007/bf02966711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/1997] [Accepted: 03/09/1998] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cystosarcoma phyllodes (CP) is a rare neoplasm of the breast. Many studies of the histology of CP have been reported. However, few reports have included an evaluation of the histologic appearance of pulmonary metastases, or the change in histologic grade as a function of time in patients with recurrent tumors. METHODS We treated two patients with pulmonary metastases, CP from 1973 to 1995. One patient died of respiratory failure. The other underwent six operations for CP. We evaluated the histologic characteristics of these metastases and changes in the histologic grade of recurrent tumors. RESULTS The primary lesions in these two cases were typical high-grade malignant tumors. Case 1 had multiple pulmonary metastases and histologic findings indicated typical malignant CP. Case 2 had a solitary pulmonary metastasis and histologic findings showed low-grade malignant CP, which could be resected. The first patient died of respiratory failure ten months after surgery. The second had no further pulmonary metastases although she had frequent local recurrences, and the histologic features of these tumors became progressively worse. CONCLUSION We suggest that patients with malignant CP be followed closely and that when pulmonary metastases are detected, they should be resected if possible, because pulmonary metastatic tumors may represent lower-grade malignant CP.
Collapse
Affiliation(s)
- T Kobayashi
- Department of Surgery II, Osaka University Medical School, Japan
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Morales-Vásquez F, Gonzalez-Angulo AM, Broglio K, Lopez-Basave HN, Gallardo D, Hortobagyi GN, De La Garza JG. Adjuvant Chemotherapy with Doxorubicin and Dacarbazine has No Effect in Recurrence-Free Survival of Malignant Phyllodes Tumors of the Breast. Breast J 2007; 13:551-6. [DOI: 10.1111/j.1524-4741.2007.00510.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
Lenhard MS, Kahlert S, Himsl I, Ditsch N, Untch M, Bauerfeind I. Phyllodes tumour of the breast: clinical follow-up of 33 cases of this rare disease. Eur J Obstet Gynecol Reprod Biol 2007; 138:217-21. [PMID: 17868973 DOI: 10.1016/j.ejogrb.2007.08.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 06/17/2007] [Accepted: 08/05/2007] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The "cystosarcoma phyllodes" of the breast is a rare entity which accounts for 0.5% of all breast neoplasms. The aim of our study was to analyse the clinical management with respect to patient outcome. STUDY DESIGN The data of 5270 patients with primary breast neoplasms treated in our department between 1984 and 2005 were retrospectively analysed for the histopathologic diagnosis of a cystosarcoma phyllodes. The clinical data was analysed with respect to tumour grading and size, treatment and prognosis. RESULTS Retrospective analysis of 5270 patients with primary breast neoplasms revealed 33 patients. In the histopathological analysis, tumour grade was classified as benign in 40%, borderline in 27% and malignant in 33% of patients. Breast conserving surgery was conducted in 58% of the patients, mastectomy in 42%. Only one patient was treated with adjuvant radiotherapy after primary surgery. Mean tumour size was 6.9 cm, and no lymph node infiltration was found in the 10 patients who received axillary lymph node dissection. Local recurrence occurred in eight patients (26%). The local recurrence rate was 50% in malignant, 20% in borderline and only 8% in benign tumours. Distant metastases were seen in three patients (9%) with malignant phyllodes tumours. Neither regarding age at primary diagnosis nor in tumour size there was a significant difference between patients with local recurrence or metastatic spread and those without (p=0.284 tumour size; p=0.739 for age; Mann-Whitney U-test). CONCLUSION Histopathological classification appears to be the strongest prognostic factor in this disease.
Collapse
Affiliation(s)
- Miriam S Lenhard
- Department of Obstetrics and Gynecology, University Hospital Munich, Ludwig-Maximilians-University of Munich, Grosshadern, Marchioninistrasse 15, Munich, Germany.
| | | | | | | | | | | |
Collapse
|
11
|
Asoglu O, Ugurlu MM, Blanchard K, Grant CS, Reynolds C, Cha SS, Donohue JH. Risk factors for recurrence and death after primary surgical treatment of malignant phyllodes tumors. Ann Surg Oncol 2005; 11:1011-7. [PMID: 15525831 DOI: 10.1245/aso.2004.02.001] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Malignant phyllodes tumor (MPT) is a rare but aggressive breast malignancy. The aim of this study was to evaluate parameters that influence outcome in patients with MPT. METHODS Fifty women were diagnosed with MPT of the breast and treated between August 1971 and July 2000. All medical records were reviewed retrospectively. The Cox regression model was used for multivariate analysis. RESULTS Tumors were classified as borderline (6%), low grade (32%), or high grade (62%). The median patient age was 46 years (range, 14-77 years). The median tumor diameter was 3.5 cm (range, 1.5-18 cm). Twenty-two patients had wide local excision (WLE), and 28 patients had mastectomy. The median follow-up was 91 months (range, 12-360 months). Local recurrence (LR) occurred in 16 patients (32%) an average of 26 months after surgery (median, 17 months; range, 3-72 months). Distant metastasis occurred in 13 patients (26%) at an average of 53.4 months (median, 36 months; range, 4-177 months). Sixteen (32%) patients have died of their disease. LR was significantly increased with stromal overgrowth (P < .0001), large tumor size (P = .0177), and surgical margins <1 cm (P = .0120), but not with WLE (P = .5099). Stromal overgrowth was the only independent variable predictive of systemic metastasis (P < .0001) and patient survival (P < .0001). CONCLUSIONS Stromal overgrowth in MPT carries a grave prognosis. Close surgical margins and large tumor size, but not type of operation, significantly increased LR. Either WLE with adequate margins or mastectomy is an appropriate treatment for patients with MPT.
Collapse
Affiliation(s)
- Oktar Asoglu
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | | | | | | | | | | | | |
Collapse
|
12
|
Kapiris I, Nasiri N, A'Hern R, Healy V, Gui GP. Outcome and predictive factors of local recurrence and distant metastases following primary surgical treatment of high-grade malignant phyllodes tumours of the breast. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2001; 27:723-30. [PMID: 11735168 DOI: 10.1053/ejso.2001.1207] [Citation(s) in RCA: 153] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AIM High-grade malignant phyllodes tumour (MPT) is a rare but aggressive breast malignancy and forms approximately 25% of all phyllodes tumours. The aim of the study was to determine parameters that influence outcome in high-grade MPT. METHODS This study consisted of 48 women diagnosed with high-grade MPT. All patients were treated primarily with surgery by local excision (LE, margins <1 cm), wide local excision (WLE, margins > or =1 cm) or mastectomy. Cox's regression was used for multivariate analysis of the data. RESULTS The mean patient age was 47 (range 21-85) years and the average tumour size was 7.8 (range 1.5-20) cm. Ten patients were treated with LE, 14 with WLE and 24 with mastectomy. The median follow-up was 9 years (range 5 months-28 years). Local recurrence (LR) occurred in 19 patients (40%) at mean time of 28 (range 5-84) months after primary treatment. Distant metastasis (DM) occurred in 13 (27%) patients at average time of 25.6 (range 6-120) months. LR, subsequent metastatic spread and survival following treatment of MPT were related to tumour size and excision margins, but not to other clinical or histopathological characteristics. CONCLUSION Tumour size and surgical margins were found to be the principal determinants of LR and DM. Complete surgical excision, by mastectomy if necessary, is important in the primary surgical treatment of high-grade MPT.
Collapse
Affiliation(s)
- I Kapiris
- Department of Academic Surgery, Breast Unit, Royal Marsden NHS Trust, London, UK
| | | | | | | | | |
Collapse
|
13
|
Abstract
Phyllodes tumours are rare fibroepithelial lesions that account for less than 1% of all breast neoplasms. With the non-operative management of fibroadenomas widely adopted, the importance of phyllodes tumours today lies in the need to differentiate them from other benign breast lesions. All breast lumps should be triple assessed and the diagnosis of a phyllodes tumour considered in women, particularly over the age of 35 years, who present with a rapidly growing "benign" breast lump. Treatment can be by either wide excision or mastectomy provided histologically clear specimen margins are ensured. Nodal metastases are rare and routine axillary dissection is not recommended. Few reliable clinical and histological prognostic factors have been identified. Local recurrence occurs in approximately 15% of patients and is more common after incomplete excision. It can usually be controlled by further surgery. Repeated local recurrence has been reported without the development of distant metastases or reduced survival. Approximately 20% of patients with malignant phyllodes tumours develop distant metastases. Long term survival with distant metastases is rare. The role of chemotherapy, radiotherapy, and hormonal manipulation in both the adjuvant and palliative settings remain to be defined.
Collapse
Affiliation(s)
- S J Parker
- Department of Surgery, University Hospital of Wales, Cardiff, Wales, UK
| | | |
Collapse
|
14
|
Barth RJ. Histologic features predict local recurrence after breast conserving therapy of phyllodes tumors. Breast Cancer Res Treat 1999; 57:291-5. [PMID: 10617306 DOI: 10.1023/a:1006260225618] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Pathologists can distinguish benign phyllodes tumors, which very rarely metastasize, from malignant phyllodes tumors, which metastasize in approximately one fourth of patients. However, whether these same histologic criteria can be used to predict the likelihood that a phyllodes tumor will locally recur after breast conserving therapy remains controversial. STUDY DESIGN Since few patients with malignant phyllodes tumors have been treated with breast conserving surgery in any individual series, the literature was reviewed using a Medline search. RESULTS After local excision, 21% (111/540), 46% (18/39), and 65% (26/40) of patients with benign, borderline, and malignant phyllodes tumors, respectively, recurred in the breast. Following wide local excision, 8% (17/212), 29% (20/68), and 36% (16/45) of patients with benign, borderline, and malignant phyllodes tumors recurred in the breast. CONCLUSIONS Malignant phyllodes tumors are much more likely than benign phyllodes tumors to recur in the breast after breast conserving surgery. This high rate of local recurrence of borderline and malignant phyllodes tumors suggests that wide local excision is less than optimal therapy, and challenges us to look for methods to improve local tumor control.
Collapse
Affiliation(s)
- R J Barth
- Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
| |
Collapse
|
15
|
Chaney AW, Pollack A, McNeese MD, Zagars GK. Adjuvant radiotherapy for phyllodes tumor of breast. RADIATION ONCOLOGY INVESTIGATIONS 1999; 6:264-7. [PMID: 9885942 DOI: 10.1002/(sici)1520-6823(1998)6:6<264::aid-roi3>3.0.co;2-j] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Our purpose was to examine the role of radiotherapy in the management of phyllodes tumor of the breast. Eight patients were treated with adjuvant radiotherapy for nonmetastatic phyllodes tumor of the breast at the M.D. Anderson Cancer Center between December 1988-August 1993. Tumors were classified as benign (n=2), borderline (indeterminate; n=1), or malignant (n=5). Median follow-up was 36.5 months. Primary surgery consisted of either lumpectomy in 2 patients or mastectomy in 6 patients. Seven patients received adjuvant radiation therapy to the breast or chest wall to a dose of 60 Gy. One patient received 50 Gy to the breast, followed by an interstitial boost of 20 Gy for a total of 70 Gy. Radiotherapy was administered for a combination of reasons, including bulky tumor volume, positive margins, recurrence, and/or malignant histology. There were no local or distant failures. This retrospective review suggests that adjuvant radiotherapy may be underutilized in the treatment of phyllodes tumor of the breast, particularly in patients with adverse features. Although treatment to the breast or chest wall (not the lymphatics) to a dose of 60 Gy appears effective, a dose-response has not been established, and lower doses (50-60 Gy) may be equally effective.
Collapse
Affiliation(s)
- A W Chaney
- Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
| | | | | | | |
Collapse
|
16
|
Radiotherapy to pulmonary metastases of a malignant phyllodes tumor of the breast. Int J Clin Oncol 1998. [DOI: 10.1007/bf02628058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
Breast Cancer Treatment LiteratureWatch. J Womens Health (Larchmt) 1994. [DOI: 10.1089/jwh.1994.3.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|