Your doctor will want to follow you closely after treatment for a phyllodes tumor. These tumors sometimes can recur locally, which means that they come back in the breast itself, or in the skin and underlying tissues of the breast if you had a mastectomy. If recurrence does happen, it usually occurs within a year or two of surgery. Malignant phyllodes tumors may recur more quickly than benign phyllodes tumors.
You and your doctor will work together to come up with a schedule of follow-up visits and exams. Your plan may include some or all of the following:
- clinical breast exam (examination of the breast by your doctor) within 4 to 6 months
- mammogram and ultrasound 6 months after treatment, and possibly breast MRI if more clarification is needed
- regular follow-up mammograms, ultrasounds, and possibly MRIs of the area where the lump was removed
- CT (computerized tomography) scans of the chest and abdomen for 2 to 5 years. These may only be recommended if you had a malignant phyllodes tumor removed, and/or if your doctor believes you are at risk for distant recurrence.
If a malignant phyllodes tumor recurs (comes back) in the breast, treatment includes wide excision or mastectomy to remove the tumor. Some doctors may recommend radiation therapy to the area after surgery, although experts don't agree on whether or not this is helpful.
Fewer than 5% of phyllodes tumors recur in other areas of the body (distant recurrence). Large tumor size (5 cm or greater) and lots of stromal overgrowth (large numbers of abnormal connective cells) are considered risk factors for distant recurrence. Possible treatments for recurrence include surgery, radiation therapy, and chemotherapy. Because phyllodes tumors are so rare, doctors often have to make treatment decisions on a case-by-case basis.