Phyllodes or Phyllodes Tumor.
This tumor is
unique to the female breast. It should be clearly
differentiated from a JUNEVILE FIBROADENOMA.
Presentation: These tumors
can be of any size but are usually diagnosed as a
large, rapidly growing, bulky breast tumor (over
5 cm in size). They can occur at any age but is
seen mostly in women in their fifties.
Presentation: These tumors have
the mammographic appearance of a fibroadenoma.
Diagnosis: The histological
diagnosis is made by excisional biopsy. Most of
these tumors are usually benign. However, a few
can be malignant. We usually request that our
pathologist classifies these tumors as, benign,
malignant or borderline Cystosarcoma Phyllodes.
Treatment: The treatment of
these tumors is surgical. As they have a
significant rate of local recurrence, surgical
local control is essential. For small benign
cystosarcoma phyllodes, a wide local excision can
be performed with meticulous, life long,
post-operative monitoring. For large tumors or
malignant / borderline tumors, a total mastectomy
is the procedure of choice. No axillary
lymphadenectomy is performed as the rate of
axillary metastasis is less than 0.9%. Some
authors have proposed a simultaneous sentinel
lymphadenectomy; although this approach is
reasonable, no guidelines have been set.
Phyllodes with metastasis: Therapeutic
guidelines are not available (lack of reported
cases and studies).
1997-98 - TransMed Network