Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins
AimTo define a predictive model for clinical behaviour of breast phyllodes tumours (PT) using histological parameters and surgical margin status.MethodsCases of breast PT diagnosed in the Department of Pathology Singapore General Hospital between January 1992 and December 2010 were stratified into b...
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| Veröffentlicht in: | Journal of clinical pathology 2012-01, Vol.65 (1), p.69-76 |
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| creator | Tan, Puay Hoon Thike, Aye Aye Tan, Wai Jin Thu, Minn Minn Myint Busmanis, Inny Li, HuiHua Chay, Wen Yee Tan, Min‐Han |
| description | AimTo define a predictive model for clinical behaviour of breast phyllodes tumours (PT) using histological parameters and surgical margin status.MethodsCases of breast PT diagnosed in the Department of Pathology Singapore General Hospital between January 1992 and December 2010 were stratified into benign, borderline and malignant grades based on a combination of histological parameters (stromal atypia, hypercellularity, mitoses, overgrowth and nature of tumour borders). Surgical margin status was assessed. Clinical follow-up and biostatistical modelling were accomplished.ResultsOf 605 PT, 440 (72.7%) were benign, 111 (18.4%) borderline and 54 (8.9%) malignant. Recurrences, which were predominantly local, were documented in 80 (13.2%) women. Deaths from PT occurred in 12 (2%) women. Multivariate analysis revealed stromal atypia, overgrowth and surgical margins to be independently predictive of clinical behaviour, with mitoses achieving near significance. Stromal hypercellularity and tumour borders were not independently useful. A nomogram developed based on atypia, mitoses, overgrowth and surgical margins (AMOS criteria) could predict recurrence-free survival at 1, 3, 5 and 10 years. This nomogram was superior to a total histological score derived from adding values assigned to each of five histological parameters.ConclusionA predictive nomogram based on three histological criteria and surgical margin status can be used to calculate recurrence-free survival of an individual woman diagnosed with PT. This can be applied for patient counselling and clinical management. |
| doi_str_mv | 10.1136/jclinpath-2011-200368 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_917574279</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4023420761</sourcerecordid><originalsourceid>FETCH-LOGICAL-b445t-3cbc6113902830bc0ae3fbbdfc15eb3658c2d0504dc89d4e552116df51e1c6d63</originalsourceid><addsrcrecordid>eNqNkUuP0zAUhSMEYsrATwBZQohVwNfPhB0qj0GMYBYDW8uvtC5JXOwE0X-PS0qRWLGxLd_vHt1zT1U9BvwCgIqXO9uHca-nbU0wQDkwFc2dagVMkpoBE3erFcYE6lYycVE9yHmHMVAJ9H51QQhmLQGxqg43ybtgpzBu0FExWN0j47f6R4hzQrFDJnmdJ7TfHvo-Op_RNA-llF8hjcY4xE3SAzI6e4fiiLYhT7GPm986NoXJp6CRHh3Kc1p-B10eY35Y3et0n_2j031ZfXn39nZ9VV9_fv9h_fq6NozxqabWWFEct5g0FBuLtaedMa6zwL2hgjeWOMwxc7ZpHfOcEwDhOg4erHCCXlbPF919it9nnyc1hGx93-vRxzmrFiSXjMi2kE__IXfF6FiGUyAbAIkZkELxhbIp5px8p_YpFE8HBVgdo1HnaNQxGrVEU_qenNRnM3h37vqTRQGenQCdy566pEcb8l-OU0GhOQrVC1dW7X-e6zp9U0JSydWnr2vVsjfw8eb2SsnC44U3w-4_Z_0FB1u5ug</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1781170412</pqid></control><display><type>article</type><title>Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins</title><source>PubMed (Medline)</source><source>BMJ Journals Online Archive</source><source>MEDLINE</source><creator>Tan, Puay Hoon ; Thike, Aye Aye ; Tan, Wai Jin ; Thu, Minn Minn Myint ; Busmanis, Inny ; Li, HuiHua ; Chay, Wen Yee ; Tan, Min‐Han</creator><creatorcontrib>Tan, Puay Hoon ; Thike, Aye Aye ; Tan, Wai Jin ; Thu, Minn Minn Myint ; Busmanis, Inny ; Li, HuiHua ; Chay, Wen Yee ; Tan, Min‐Han ; Phyllodes Tumour Network Singapore ; The Phyllodes Tumour Network Singapore</creatorcontrib><description>AimTo define a predictive model for clinical behaviour of breast phyllodes tumours (PT) using histological parameters and surgical margin status.MethodsCases of breast PT diagnosed in the Department of Pathology Singapore General Hospital between January 1992 and December 2010 were stratified into benign, borderline and malignant grades based on a combination of histological parameters (stromal atypia, hypercellularity, mitoses, overgrowth and nature of tumour borders). Surgical margin status was assessed. Clinical follow-up and biostatistical modelling were accomplished.ResultsOf 605 PT, 440 (72.7%) were benign, 111 (18.4%) borderline and 54 (8.9%) malignant. Recurrences, which were predominantly local, were documented in 80 (13.2%) women. Deaths from PT occurred in 12 (2%) women. Multivariate analysis revealed stromal atypia, overgrowth and surgical margins to be independently predictive of clinical behaviour, with mitoses achieving near significance. Stromal hypercellularity and tumour borders were not independently useful. A nomogram developed based on atypia, mitoses, overgrowth and surgical margins (AMOS criteria) could predict recurrence-free survival at 1, 3, 5 and 10 years. This nomogram was superior to a total histological score derived from adding values assigned to each of five histological parameters.ConclusionA predictive nomogram based on three histological criteria and surgical margin status can be used to calculate recurrence-free survival of an individual woman diagnosed with PT. This can be applied for patient counselling and clinical management.</description><identifier>ISSN: 0021-9746</identifier><identifier>EISSN: 1472-4146</identifier><identifier>DOI: 10.1136/jclinpath-2011-200368</identifier><identifier>PMID: 22049216</identifier><identifier>CODEN: JCPAAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Association of Clinical Pathologists</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Biopsy ; breast ; breast cancer ; Breast Neoplasms - diagnosis ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; breast pathology ; cancer ; cancer genetics ; cancer research ; Cell Proliferation ; Chi-Square Distribution ; Classification ; Disease-Free Survival ; Female ; Gynecology. Andrology. Obstetrics ; Hospitals, General ; Humans ; immunohistochemistry ; Investigative techniques, diagnostic techniques (general aspects) ; Kaplan-Meier Estimate ; Likelihood Functions ; Mammary gland diseases ; Mastectomy - statistics & numerical data ; Medical prognosis ; Medical sciences ; Metastasis ; Middle Aged ; Mitotic Index ; Models, Biological ; Multivariate analysis ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Nomogram ; Nomograms ; Pathology ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; phyllodes ; Phyllodes Tumor - diagnosis ; Phyllodes Tumor - mortality ; Phyllodes Tumor - secondary ; Phyllodes Tumor - surgery ; prediction ; Predictive Value of Tests ; Proportional Hazards Models ; prostate ; recurrence ; Risk Assessment ; Risk Factors ; Singapore ; Statistical analysis ; surgical margin ; Time Factors ; Treatment Outcome ; Tumors ; Young Adult</subject><ispartof>Journal of clinical pathology, 2012-01, Vol.65 (1), p.69-76</ispartof><rights>2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2011 (c) 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b445t-3cbc6113902830bc0ae3fbbdfc15eb3658c2d0504dc89d4e552116df51e1c6d63</citedby><cites>FETCH-LOGICAL-b445t-3cbc6113902830bc0ae3fbbdfc15eb3658c2d0504dc89d4e552116df51e1c6d63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jcp.bmj.com/content/65/1/69.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://jcp.bmj.com/content/65/1/69.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3182,4009,23551,27902,27903,27904,77347,77378</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25363188$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22049216$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tan, Puay Hoon</creatorcontrib><creatorcontrib>Thike, Aye Aye</creatorcontrib><creatorcontrib>Tan, Wai Jin</creatorcontrib><creatorcontrib>Thu, Minn Minn Myint</creatorcontrib><creatorcontrib>Busmanis, Inny</creatorcontrib><creatorcontrib>Li, HuiHua</creatorcontrib><creatorcontrib>Chay, Wen Yee</creatorcontrib><creatorcontrib>Tan, Min‐Han</creatorcontrib><creatorcontrib>Phyllodes Tumour Network Singapore</creatorcontrib><creatorcontrib>The Phyllodes Tumour Network Singapore</creatorcontrib><title>Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins</title><title>Journal of clinical pathology</title><addtitle>J Clin Pathol</addtitle><description>AimTo define a predictive model for clinical behaviour of breast phyllodes tumours (PT) using histological parameters and surgical margin status.MethodsCases of breast PT diagnosed in the Department of Pathology Singapore General Hospital between January 1992 and December 2010 were stratified into benign, borderline and malignant grades based on a combination of histological parameters (stromal atypia, hypercellularity, mitoses, overgrowth and nature of tumour borders). Surgical margin status was assessed. Clinical follow-up and biostatistical modelling were accomplished.ResultsOf 605 PT, 440 (72.7%) were benign, 111 (18.4%) borderline and 54 (8.9%) malignant. Recurrences, which were predominantly local, were documented in 80 (13.2%) women. Deaths from PT occurred in 12 (2%) women. Multivariate analysis revealed stromal atypia, overgrowth and surgical margins to be independently predictive of clinical behaviour, with mitoses achieving near significance. Stromal hypercellularity and tumour borders were not independently useful. A nomogram developed based on atypia, mitoses, overgrowth and surgical margins (AMOS criteria) could predict recurrence-free survival at 1, 3, 5 and 10 years. This nomogram was superior to a total histological score derived from adding values assigned to each of five histological parameters.ConclusionA predictive nomogram based on three histological criteria and surgical margin status can be used to calculate recurrence-free survival of an individual woman diagnosed with PT. This can be applied for patient counselling and clinical management.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>breast</subject><subject>breast cancer</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>breast pathology</subject><subject>cancer</subject><subject>cancer genetics</subject><subject>cancer research</subject><subject>Cell Proliferation</subject><subject>Chi-Square Distribution</subject><subject>Classification</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Hospitals, General</subject><subject>Humans</subject><subject>immunohistochemistry</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Kaplan-Meier Estimate</subject><subject>Likelihood Functions</subject><subject>Mammary gland diseases</subject><subject>Mastectomy - statistics & numerical data</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Mitotic Index</subject><subject>Models, Biological</subject><subject>Multivariate analysis</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Recurrence, Local</subject><subject>Nomogram</subject><subject>Nomograms</subject><subject>Pathology</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>phyllodes</subject><subject>Phyllodes Tumor - diagnosis</subject><subject>Phyllodes Tumor - mortality</subject><subject>Phyllodes Tumor - secondary</subject><subject>Phyllodes Tumor - surgery</subject><subject>prediction</subject><subject>Predictive Value of Tests</subject><subject>Proportional Hazards Models</subject><subject>prostate</subject><subject>recurrence</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Singapore</subject><subject>Statistical analysis</subject><subject>surgical margin</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Young Adult</subject><issn>0021-9746</issn><issn>1472-4146</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkUuP0zAUhSMEYsrATwBZQohVwNfPhB0qj0GMYBYDW8uvtC5JXOwE0X-PS0qRWLGxLd_vHt1zT1U9BvwCgIqXO9uHca-nbU0wQDkwFc2dagVMkpoBE3erFcYE6lYycVE9yHmHMVAJ9H51QQhmLQGxqg43ybtgpzBu0FExWN0j47f6R4hzQrFDJnmdJ7TfHvo-Op_RNA-llF8hjcY4xE3SAzI6e4fiiLYhT7GPm986NoXJp6CRHh3Kc1p-B10eY35Y3et0n_2j031ZfXn39nZ9VV9_fv9h_fq6NozxqabWWFEct5g0FBuLtaedMa6zwL2hgjeWOMwxc7ZpHfOcEwDhOg4erHCCXlbPF919it9nnyc1hGx93-vRxzmrFiSXjMi2kE__IXfF6FiGUyAbAIkZkELxhbIp5px8p_YpFE8HBVgdo1HnaNQxGrVEU_qenNRnM3h37vqTRQGenQCdy566pEcb8l-OU0GhOQrVC1dW7X-e6zp9U0JSydWnr2vVsjfw8eb2SsnC44U3w-4_Z_0FB1u5ug</recordid><startdate>201201</startdate><enddate>201201</enddate><creator>Tan, Puay Hoon</creator><creator>Thike, Aye Aye</creator><creator>Tan, Wai Jin</creator><creator>Thu, Minn Minn Myint</creator><creator>Busmanis, Inny</creator><creator>Li, HuiHua</creator><creator>Chay, Wen Yee</creator><creator>Tan, Min‐Han</creator><general>BMJ Publishing Group Ltd and Association of Clinical Pathologists</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201201</creationdate><title>Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins</title><author>Tan, Puay Hoon ; Thike, Aye Aye ; Tan, Wai Jin ; Thu, Minn Minn Myint ; Busmanis, Inny ; Li, HuiHua ; Chay, Wen Yee ; Tan, Min‐Han</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b445t-3cbc6113902830bc0ae3fbbdfc15eb3658c2d0504dc89d4e552116df51e1c6d63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>breast</topic><topic>breast cancer</topic><topic>Breast Neoplasms - diagnosis</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>breast pathology</topic><topic>cancer</topic><topic>cancer genetics</topic><topic>cancer research</topic><topic>Cell Proliferation</topic><topic>Chi-Square Distribution</topic><topic>Classification</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Hospitals, General</topic><topic>Humans</topic><topic>immunohistochemistry</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Kaplan-Meier Estimate</topic><topic>Likelihood Functions</topic><topic>Mammary gland diseases</topic><topic>Mastectomy - statistics & numerical data</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Mitotic Index</topic><topic>Models, Biological</topic><topic>Multivariate analysis</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Recurrence, Local</topic><topic>Nomogram</topic><topic>Nomograms</topic><topic>Pathology</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>phyllodes</topic><topic>Phyllodes Tumor - diagnosis</topic><topic>Phyllodes Tumor - mortality</topic><topic>Phyllodes Tumor - secondary</topic><topic>Phyllodes Tumor - surgery</topic><topic>prediction</topic><topic>Predictive Value of Tests</topic><topic>Proportional Hazards Models</topic><topic>prostate</topic><topic>recurrence</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Singapore</topic><topic>Statistical analysis</topic><topic>surgical margin</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tan, Puay Hoon</creatorcontrib><creatorcontrib>Thike, Aye Aye</creatorcontrib><creatorcontrib>Tan, Wai Jin</creatorcontrib><creatorcontrib>Thu, Minn Minn Myint</creatorcontrib><creatorcontrib>Busmanis, Inny</creatorcontrib><creatorcontrib>Li, HuiHua</creatorcontrib><creatorcontrib>Chay, Wen Yee</creatorcontrib><creatorcontrib>Tan, Min‐Han</creatorcontrib><creatorcontrib>Phyllodes Tumour Network Singapore</creatorcontrib><creatorcontrib>The Phyllodes Tumour Network Singapore</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tan, Puay Hoon</au><au>Thike, Aye Aye</au><au>Tan, Wai Jin</au><au>Thu, Minn Minn Myint</au><au>Busmanis, Inny</au><au>Li, HuiHua</au><au>Chay, Wen Yee</au><au>Tan, Min‐Han</au><aucorp>Phyllodes Tumour Network Singapore</aucorp><aucorp>The Phyllodes Tumour Network Singapore</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins</atitle><jtitle>Journal of clinical pathology</jtitle><addtitle>J Clin Pathol</addtitle><date>2012-01</date><risdate>2012</risdate><volume>65</volume><issue>1</issue><spage>69</spage><epage>76</epage><pages>69-76</pages><issn>0021-9746</issn><eissn>1472-4146</eissn><coden>JCPAAK</coden><abstract>AimTo define a predictive model for clinical behaviour of breast phyllodes tumours (PT) using histological parameters and surgical margin status.MethodsCases of breast PT diagnosed in the Department of Pathology Singapore General Hospital between January 1992 and December 2010 were stratified into benign, borderline and malignant grades based on a combination of histological parameters (stromal atypia, hypercellularity, mitoses, overgrowth and nature of tumour borders). Surgical margin status was assessed. Clinical follow-up and biostatistical modelling were accomplished.ResultsOf 605 PT, 440 (72.7%) were benign, 111 (18.4%) borderline and 54 (8.9%) malignant. Recurrences, which were predominantly local, were documented in 80 (13.2%) women. Deaths from PT occurred in 12 (2%) women. Multivariate analysis revealed stromal atypia, overgrowth and surgical margins to be independently predictive of clinical behaviour, with mitoses achieving near significance. Stromal hypercellularity and tumour borders were not independently useful. A nomogram developed based on atypia, mitoses, overgrowth and surgical margins (AMOS criteria) could predict recurrence-free survival at 1, 3, 5 and 10 years. This nomogram was superior to a total histological score derived from adding values assigned to each of five histological parameters.ConclusionA predictive nomogram based on three histological criteria and surgical margin status can be used to calculate recurrence-free survival of an individual woman diagnosed with PT. This can be applied for patient counselling and clinical management.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and Association of Clinical Pathologists</pub><pmid>22049216</pmid><doi>10.1136/jclinpath-2011-200368</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Biological and medical sciences Biopsy breast breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - mortality Breast Neoplasms - pathology Breast Neoplasms - surgery breast pathology cancer cancer genetics cancer research Cell Proliferation Chi-Square Distribution Classification Disease-Free Survival Female Gynecology. Andrology. Obstetrics Hospitals, General Humans immunohistochemistry Investigative techniques, diagnostic techniques (general aspects) Kaplan-Meier Estimate Likelihood Functions Mammary gland diseases Mastectomy - statistics & numerical data Medical prognosis Medical sciences Metastasis Middle Aged Mitotic Index Models, Biological Multivariate analysis Neoplasm Grading Neoplasm Recurrence, Local Nomogram Nomograms Pathology Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques phyllodes Phyllodes Tumor - diagnosis Phyllodes Tumor - mortality Phyllodes Tumor - secondary Phyllodes Tumor - surgery prediction Predictive Value of Tests Proportional Hazards Models prostate recurrence Risk Assessment Risk Factors Singapore Statistical analysis surgical margin Time Factors Treatment Outcome Tumors Young Adult |
| title | Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins |
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