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Competing cardiovascular and tumor-specific mortality in malignant phyllodes tumor
İsmail Zihni1, Burcu Zihni2, Mehmet Zafer Sabuncuoğlu1
1Department of General Surgery, Akdeniz University Medical Faculty, Antalya, Türkiye.
Biomolecules & Biomedicine
|August 5, 2026
Summary
Malignant phyllodes tumors are rare, with phyllodes-specific death being the primary long-term risk. Apparent excess cardiovascular mortality in patients is due to incorrect data analysis, not increased risk.
Area of Science:
- Oncology
- Epidemiology
- Cardiovascular Research
Background:
- Malignant phyllodes tumors of the breast are rare neoplasms.
- Long-term mortality causes for this condition are not well understood.
Purpose of the Study:
- To quantify phyllodes-specific and cardiovascular mortality in malignant phyllodes tumor patients.
- To determine if cardiovascular mortality in these patients exceeds general population rates.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database (2000-2020) for women with malignant phyllodes tumor.
- Employed competing-risk methods for mortality evaluation.
- Calculated standardized mortality ratios (SMRs) for cardiovascular causes using age and calendar period standardization.
Main Results:
- Phyllodes-specific mortality was the dominant cause of death (180-month cumulative incidence: 14.6%) compared to cardiovascular mortality (4.4%).
- Corrected age and calendar period standardization showed no elevated cardiovascular mortality (SMR 0.92-1.00).
- Incorrect person-time allocation led to an inflated SMR of 1.95, suggesting a false excess risk.
Conclusions:
- Phyllodes-specific death remains the principal long-term mortality risk for malignant phyllodes tumor.
- Apparent excess cardiovascular mortality is an artifact of incorrect statistical methodology, not a true increase in risk.
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