乳腺叶状肿瘤（Phyllodes tumors, PTs）是罕见的乳腺肿瘤。目前的国家综合癌症网络（National Comprehensive Cancer Network, NCCN）指南建议切除良性PTs，接受近距离或阳性边缘。对于良性PTs的最佳治疗方法仍存在争议，特别是对于手术切除后首选的边缘宽度和随访评估的需求。一项全国性回顾性研究分析了荷兰人口从1989年到2022年的情况。通过在荷兰全国病理数据库（Palga）中进行搜索，确定了所有诊断为良性PTs的患者。收集了有关年龄、诊断年份、原发肿瘤大小、手术治疗、手术边缘状态和局部复发的信息。研究纳入了1908例良性PTs患者。诊断时的中位年龄为43岁（四分位数范围[IQR]，34-52岁），中位肿瘤大小为30mm（IQR，19-40mm）。大多数患者（95%）接受了保乳手术（BCS）。总体局部复发率为6.2%，局部复发的中位时间为31个月（IQR，15-61个月）。局部复发与肿瘤双侧性相关（比值比[OR]，4.91；95%置信区间[CI]，2.95-28.30）和阳性边缘状态相关（OR，2.51；95% CI，1.36-4.63）。阳性切除边缘患者的局部复发率为8.9%，阴性切除边缘患者的局部复发率为4.0%。值得注意的是，27名患者（22.6%）出现了局部复发，其中报告了复发肿瘤的组织学升级，其中7名（5.9%）患者的复发为恶性病变。这项纳入1908名患者的全国系列研究显示，良性PTs的局部复发率较低，为6.2%，阳性边缘患者的复发率较高。© 2023. 外科肿瘤学学会 (Society of Surgical Oncology)。

Phyllodes tumors (PTs) are rare tumors of the breast. The current National Comprehensive Cancer Network (NCCN) guidelines recommend excision of benign PTs, accepting close or positive margins. Controversy about the optimal treatment for benign PTs remains, especially regarding the preferred margin width after surgical excision and the need for follow-up evaluation.A nationwide retrospective study analyzed the Dutch population from 1989 to 2022. All patients with a diagnosis of benign PT were identified through a search in the Dutch nationwide pathology databank (Palga). Information on age, year of diagnosis, size of the primary tumor, surgical treatment, surgical margin status, and local recurrence was collected.The study enrolled 1908 patients with benign PT. The median age at diagnosis was 43 years (interquartile range [IQR], 34-52 years), and the median tumor size was 30 mm (IQR, 19-40 mm). Most of the patients (95%) were treated with breast-conserving surgery (BCS). The overall local recurrence rate was 6.2%, and the median time to local recurrence was 31 months (IQR, 15-61 months). Local recurrence was associated with bilaterality of the tumor (odds ratio [OR], 4.91; 95% confidence interval [CI], 2.95-28.30) and positive margin status (OR, 2.51; 95% CI 1.36-4.63). The local recurrence rate was 8.9% for the patients with positive excision margins and 4.0% for the patients with negative excision margins. Notably, for 27 patients (22.6%) who experienced a local recurrence, histologic upgrading of the recurrent tumor was reported, 7 (5.9%) of whom had recurrence as malignant lesions.This nationwide series of 1908 patients showed a low local recurrence rate of 6.2% for benign PT, with higher recurrence rates following positive margins.© 2023. Society of Surgical Oncology.