{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T22:45:55Z","timestamp":1778453155618,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malignant phyllodes tumors (MPT) are rare, aggressive fibroepithelial breast neoplasms with limited consensus on optimal management. While wide local excision (WLE) with \u22651\u00a0cm margins is standard, recurrence remains common, and the role of adjuvant therapy remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a 28-year retrospective review of 14 histologically confirmed MPTs in 11 patients at a single urban safety-net hospital. Clinical, pathologic, and treatment data were analyzed to assess recurrence, metastasis, and treatment outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median tumor size was 7.6\u00a0cm. Most patients (73%) presented with stage II disease. Surgical management included WLE alone (45.5%), WLE with radiation (27.3%), mastectomy alone (9.1%), and mastectomy with adjuvant radiation (18.2%). Local recurrence occurred in 3 patients (27.3%), all of whom were initially treated with surgery alone. Those who recurred received adjuvant radiation; no recurrences occurred after adjuvant radiation. One patient developed metastases and received systemic chemotherapy. Only 1 patient underwent genetic testing, which revealed a\n                      <jats:italic toggle=\"yes\">TP53<\/jats:italic>\n                      mutation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Recurrence occurred often despite margin-negative resections, highlighting the limitations of current surgical guidelines and the potential importance of tumor biology. These findings support a more individualized treatment approach that incorporates histologic features and, when appropriate, genetic testing. Adjuvant radiation may reduce the risk of recurrence in high-risk cases, although our small cohort precludes definitive conclusions. These findings should be considered hypothesis-generating and highlight the need for prospective or registry-based studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251412264","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T13:44:31Z","timestamp":1767015871000},"page":"1790-1798","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Definitive Management of Malignant Phyllodes of the Breast"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1282-5442","authenticated-orcid":false,"given":"Casey A.","family":"Hamlet","sequence":"first","affiliation":[{"name":"Rutgers New Jersey Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7637-4844","authenticated-orcid":false,"given":"Hima Bindu","family":"Thota","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emi B.","family":"Daria","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise J.","family":"Zieba","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm D.","family":"Mattes","sequence":"additional","affiliation":[{"name":"Rutgers Cancer Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankit S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David I.","family":"Suster","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7315-9993","authenticated-orcid":false,"given":"Susan E.","family":"Pories","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School"},{"name":"Rutgers New Jersey Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/his.14091"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/his.12876"},{"key":"e_1_3_6_4_2","volume-title":"Phyllodes Tumor Pathologyoutlines","author":"Li J","unstructured":"Li J, Tse G. 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