Phyllodes Tumor

Phyllodes Tumor account for 1% of breast neoplasms.

  • They present as a large, smooth, lobulated mass and may be difficult to distinguish from fibroadenoma on physical exam.
  • They can occur in women of any age, but most frequently between ages 35 and 55 years.
  • Skin ulcerations may occur secondary to pressure of the underlying mass.
  • FNAB cannot reliably diagnose these tumors; at least a core needle biopsy is needed. Histologically, stromal overgrowth is the essential characteristic for differentiating Phyllodes Tumor from fibroadenomas.
  • Ninety percent are benign; 10% are malignant. The biologic behavior of malignant tumors is similar to that of sarcomas.
  • Treatment is wide local excision to tumor-free margins or total mastectomy. Axillary assessment with either SLNB or ALND is not indicated unless nodes are clinically positive (which is rare).
  • Currently, there is no role for adjuvant radiation; however, tumors greater than 5 cm in diameter and with evidence of stromal overgrowth may benefit from adjuvant chemotherapy with doxorubicin and ifosfamide (Cancer 2000;89:1510).
  • Patients should be followed with semiannual physical examinations and annual mammograms and chest radiographs.