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Phyllodes Tumors of the Breast (Malignant)  

Phyllodes tumors of the breast is a very rare form of breast cancer.  It can be either benign or malignant.  We will discuss the malignant form here.  The tumor forms in the connective tissue which surrounds and supports the breast rather than it the epithelial tissue which is the kind of tissue which lines the milk ducts and lobules. 

This type of breast cancer only account for about 1% of all breast cancers diagnosed in the US.   

If a phyllodes tumor forms, it typically feels like a firm and smooth sided lump in the breast.  The skin over the tumor may appear red and feel warm to the touch.  This kind of tumor tends to grow very quickly so the lump can grow much bigger in a matter of weeks. 

The disease tends to strike premenopausal women and in some rare cases can affect adolescent girls as well. 

A typical test used to diagnose any kind of breast cancer is a mammogram.  On a mammogram, the Phyllodes tumor will have a well-defined edge.  However this test alone cannot distinguish this tumor from a fibroadenomas or whether it is a benign or malignant tumor. 

If cells from a needle biopsy are taken, they may not always be able to give a clear diagnosis so an open surgical biopsy is usually done to provide a larger slice of tissue which can be properly analyzed for an accurate diagnosis. 

Although most types of breast cancer are classified into four stages, a Phyllodes tumor is not classified in the same manner.  When the cells are analyzed by a pathologist, they consider two characteristics.  One is the speed at which the cells are dividing and the other is the number of irregularly shaped cells.  Depending on these characteristics, the tumor will be classified as either benign or malignant.  About 60 to 70% of all Phyllodes tumors turn out to be benign and these benign tumors tend to be more common with younger women.  So as women age, the tendency for these tumors to become either borderline cancerous or malignant increases. 

If the diagnosis confirms a Phyllodes tumor, the standard course of treatment is surgery.  This type of tumor does not respond well to radiation therapy, chemotherapy or hormonal therapy so surgical removal is the best course of action. 

 

Malignant tumors may be surgically removed from the breast through either a wide local excision or a mastectomy may be the best course of action.  The prognosis for patients affected by Phyllodes tumors is generally good. 

 

If the tumor has remained localized then the surgical procedure is usually successful at removing virtually all of the cancerous tissue.  However there is a risk that the cancer can return even years after the initial treatment so it is very important to watch for recurring symptoms and receive regular checkups and diagnostic tests. 

 

In some cases the cancer can return and metastasize in other areas of the body.  But close observation and regular checkups can hopefully minimize the risk reoccurrence and catch the cancer while it is still in the early stages so that follow on treatment can be much more successful.