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Phyllodes Tumors

Most Phyllodes tumors are benign, but 10 percent are malignant (cancerous). Cancerous Phyllodes tumors are an unusual presentation of breast cancer. These tumors are a form of sarcoma because they grow in the connective tissue of the breast, not in the ducts. This cancer is so rare that a confirmation by a second pathologist is required.

What are the symptoms of Phyllodes tumors?

These tumors will usually present as a breast lump. These tumors can grow very fast, so it is important to have them evaluated as soon as possible. Symptoms can also mimic those of other types of breast cancer.

How are Phyllodes tumors diagnosed?

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Evaluation of any new breast lump includes clinical examination, breast imaging and needle biopsy. Phyllodes tumors often look similar to benign fibroadenomas (please link the word fibroadenoma) on mammography and ultrasound.  Core needle biopsy can be inconclusive as well because it is often difficult to distinguish benign phyllodes tumor from  cellular fibroadenomas, and malignant phyllodes tumors can be confused with other malignant spindle cell tumors such as primary spindle cell sarcoma or spindle-type metaplastic breast cancer.   It is frequently necessary to completely excise the lump to get a definitive diagnosis.

At our Breast Center, most women can learn within 24 hours of being seen by our team of breast cancer specialists whether they have breast cancer. We follow strict guidelines for biopsies and pathology reports. Our patients will receive the probability of cancer immediately following their biopsy procedure, and a pathology confirmation usually within 24 hours.

Learn more about the steps of diagnosis, including:

What is the treatment for Phyllodes tumors?

Phyllodes tumors are treated by complete excision.  If they are very large, this may require mastectomy.  A skilled pathologist is essential to the management of phyllodes tumors.  Benign phyllodes tumors with low risk features can be managed by limited excision that preserves the size and shape of the breast.  Malignant phyllodes tumors or phyllodes with high risk features are managed with more extensive surgery.

For malignant (cancerous) tumors, depending on the stage and growth of the tumor, your physician may recommend a combination of any of the following:

  • Lumpectomy – When this procedure is performed, a 1 cm margin of normal tissue is usually taken all around the  tumor since leaving any remnants of the tumor can cause it to regenerate.
  • Mastectomy
  • Radiation

What is the prognosis for Phyllodes tumors?

Prognosis is excellent for benign phyllodes tumors.  Most women with malignant phyllodes tumors are cured with appropriate treatment but these tumors can recur in the breast and metastasize to the lungs.