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Validation of the Singapore nomogram for outcome prediction in breast phyllodes tumours in a large patient cohort
  1. Tze Wei Chng1,
  2. Mihir Gudi2,
  3. Swee Ho Lim3,
  4. HuiHua Li4,
  5. Puay Hoon Tan5
  1. 1Department of Anatomic Pathology, Singapore General Hospital, Singapore
  2. 2Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
  3. 3Department of Breast Surgery, KK Women's and Children's Hospital, Singapore
  4. 4Division of Medicine, Singapore General Hospital, Singapore
  5. 5Division of Pathology, Singapore General Hospital, Singapore
  1. Correspondence to Dr Puay Hoon Tan, Division of Pathology, Singapore General Hospital, Academia 169856, Singapore; tan.puay.hoon{at}singhealth.com.sg

Abstract

Aims To validate the Singapore nomogram for outcome prediction in breast phyllodes tumours in a large cohort of Singaporean patients, as previous validation studies were conducted on small numbers of patients. We also investigate the association of fibroadenomas and phyllodes tumours within a subset of our cohort.

Methods Histological parameters, surgical margin status and clinical follow-up data of 259 women diagnosed with phyllodes tumours were analysed. Patients with concurrent malignant or premalignant disease were excluded from the validation to minimise confounding influences. Biostatistics modelling was performed, and the concordance between predicted and observed survivals was calculated. The association between fibroadenomas and phyllodes tumours was quantified in a subset of the women.

Results Phyllodes tumours with higher number of mitoses, stromal overgrowth and positive surgical margins were found to be associated with greater risk of clinical recurrence. Patients with a higher nomogram score had a significantly higher risk of developing relapse. Forty out of 78 (51.3%) of the subset of phyllodes cases reviewed showed either fibroadenoma-like areas within the phyllodes tumours or concurrent fibroadenomas in the ipsilateral or contralateral breast.

Conclusions The Singapore nomogram is useful in predicting outcome in breast phyllodes tumours when applied to a large cohort of Singaporean women.

  • breast pathology
  • histopathology

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Footnotes

  • Handling editor Tahir S Pillay.

  • Contributors TWC, Data review and manuscript preparation. MG, Histology review and data review. SHL, Clinical data review. HHL, Statistical analysis. PHT, Supervision and manuscript preparation.

  • Competing interests None declared.

  • Ethics approval Sing Health Centralised Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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