Postoperative follow-up practice of phyllodes tumour in the UK: Results from a national survey

• Published in: The surgeon (Edinburgh) Vol. 16; no. 2; pp. 74 - 81
• Main Authors: Amer, Aimen, Ainley, Paul, Thompson, Ronald, Mathers, Helen
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01-04-2018
• Subjects: Breast surgery; Follow up; Guidelines; Phyllodes tumour; Questionnaire; Surgery; Follow up; CE; Questionnaire; ultrasound scan; PT; USS; MMG; Breast surgery; clinical examination; mammogram; Phyllodes tumour; Guidelines
• ISSN: 1479-666X; 2405-5840
• DOI: 10.1016/j.surge.2016.05.003

Abstract Background Resected phyllodes tumours (PT) of the breast carry a small but significant risk of recurrence. Nevertheless, there are no national guidelines on the postoperative follow-up of these tumours potentially resulting in a wide variation in practice among breast surgeons in the UK. Methods A web-based questionnaire was sent to breast surgeons across the UK to assess individual follow-up practices including availability of local guidelines, methods of follow-up and influence of risk factors. Results Only 38% of 121 responses indicated the availability of local guidelines on PT follow-up. Modal follow-up duration for borderline and malignant disease was 5 years (53.7% and 79.3% of responses respectively), compared to 1 year for benign disease (43%) although 28% of respondents continue to review benign cases for 5 years. Immediate post-operative discharge and self-directed aftercare for benign and borderline cases remains uncommon practice in the UK. Within hospitals represented by more than one respondent in this survey, only around 30% demonstrated consistent practices pertaining to length and frequency of postoperative PT follow-up. Recurrent disease and margin status influenced the follow-up practice of 60% of respondents in our survey. More than 75% indicated that they combine clinical examination with radiological investigations (mammography and/or ultrasound) to follow up PT postoperatively. Conclusion This survey highlights the wide variation in follow-up practice for resected PT. This may affect the detection of disease relapse or, conversely, result in wasted clinical resources and unnecessary patient distress. Evidence-based national guidelines are necessary to resolve this issue and inform best follow-up practice.