Phyllodes Tumors of the Breast: Canadian National Consensus Document Using Modified Delphi Methodology
Jessica Bogach1, Apishanthi Sriskandarajah2, Frances C Wright3,4
1Department of Surgery, McMaster University, Hamilton, ON, Canada. Bogachj@mcmaster.ca.
Purpose:
Phyllodes tumors are rare breast neoplasms with limited prospective data to guide treatment, leading to heterogeneous management of this disease. We developed National consensus statements using modified Delphi methodology including patients and practitioners across Canada.
Methods:
Statements were developed based on a literature review. Two iterations of surveys were distributed with a planned virtual consensus meeting. Panelists were invited from surgery, radiation oncology, medical oncology, pathology, radiology, and plastic surgery.
Results:
Twenty-three participants attended the virtual conference. One hundred statements regarding diagnostics, pathology, surgical planning, adjuvant therapies, recurrence, surveillance, and patient support were approved with an a priori defined consensus of ≥ 80%. Two tables on locoregional management were developed and approved. The management of borderline phyllodes tumors was a source of uncertainty, and recommendations reflect the lack of evidence in this rare presentation.
Conclusion:
A consensus document containing all approved statements for the care and management of phyllodes tumors was developed to help guide practice and future research.
