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Cancerous Phyllodes Tumors of the Breast

Phyllodes tumors are rare and make up fewer than 1% of all breast tumors. Phyllodes tumors start in the stroma, the connective tissue of the breast.
 

Phyllodes tumors are rare and make up fewer than 1% of all breast tumors. Phyllodes tumors start in the stroma, the connective tissue of the breast.

The name comes from the Greek word for leaf because the cells grow in a pattern that looks like a leaf.

According to the American Cancer Society, about 75% of phyllodes tumors are non-cancerous and 25% are cancerous.

Cancerous phyllodes tumors are a form of breast cancer, but are very different from invasive ductal carcinoma, cancer that starts in the milk ducts.

 

Symptoms of phyllodes tumors of the breast

The most common symptom of a phyllodes tumor is a breast lump. It doesn’t matter if a phyllodes tumor is non-cancerous or cancerous, it tends to grow quickly and stretch the skin. In some cases, the lump may be painful.

 

Diagnosis of phyllodes tumors of the breast

Diagnosing a phyllodes tumor usually involves a combination of procedures, including:

When first found by a mammogram, it can be hard to tell the difference between a phyllodes tumor and a fibroadenoma, the most common type of benign breast tumor.

In some cases, your doctor will be able to make a diagnosis after a biopsy, but in other cases, the entire tumor will need to be removed before your doctor can tell what kind of tumor it is and whether it’s cancerous or not.

 

Treatment of phyllodes tumors of the breast

Whether the phyllodes tumor is cancerous or non-cancerous, the first treatment is always surgery:

  • lumpectomy is the most common surgery done to remove a phyllodes tumor; the tumor, plus a margin of healthy, cancer-free tissue around it is removed

  • mastectomy may be done if a margin of cancer-free tissue can’t be removed with the tumor during lumpectomy

It’s rare for phyllodes tumors to spread to the lymph nodes, so lymph node surgery usually isn’t needed.

If the phyllodes tumor is cancerous, radiation therapy may be given to the area where the tumor was after surgery.

Cancerous phyllodes tumors don’t usually respond well to common breast cancer treatments, such as hormonal therapy and chemotherapy. Still, if the phyllodes tumor has spread to other parts of the body, you’ll usually be treated with chemotherapy.

 

Survivorship care after treatment for phyllodes tumors of the breast

Phyllodes tumors can come back, either in the breast, if you had lumpectomy, or in the skin and underlying tissues of the breast, if you had mastectomy. In very, very rare cases, phyllodes tumors may come back in a part of the body away from the breast.

So you and your doctor will develop a survivorship care plan that will likely include more frequent screening, including:

Reviewed by 1 medical adviser
 
Jenni Sheng, MD
Johns Hopkins University School of Medicine, Baltimore, MD
Learn more about our advisory board

— Last updated on January 20, 2022, 6:58 PM