what does a phyllodes tumor look like

How can you tell if a tumor is phyllodes?

Phyllodes tumors are usually felt as a firm, painless breast lump, but some may hurt. They tend to grow large fairly quickly, and they often stretch the skin. Sometimes these tumors are seen first on an imaging test (like an ultrasound or mammogram), in which case they're often hard to tell apart from fibroadenomas.

Is a phyllodes tumor considered cancer?

Phyllodes (fil-oy-deez) tumors are a rare form of breast tumor; they can be benign (not cancerous), malignant (cancerous), or borderline (having characteristics of both).

Why do phyllodes tumors need to be removed?

Wide excision surgery removes the phyllodes tumor along with some of the healthy breast tissue around it. This helps prevent your tumor from growing back. Lumpectomy is surgery to remove the tumor and at least 1 centimeter of healthy breast tissue around it.

What percent of phyllodes tumors are cancerous?

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.

Can phyllodes tumor turn cancerous?

Malignant transformation of phyllodes tumor is a very rare form of breast cancer. Only some reports show malignant transformation from a benign phyllodes tumor 13, 17, 18, 19, 20. We report one case of a benign phyllodes tumor that transformed into a malignant phyllodes tumor during its recurrence.

Where do phyllodes tumors spread?

Though lungs and bone are common sites of metastasis in malignant phyllodes tumors [11], our patient had metastasis to adrenal and brain which is rare. The duration of metastasis after surgery is 7 months to 6 years in literature [9], however our case developed it early in 3 months.

Can phyllodes tumor cause death?

Symptoms of metastatic involvement can arise from as early as a few months to as late as 12 years after initial therapy. Most patients with metastases die within 3 years of initial treatment. No cures for systemic metastases exist. Roughly 30% of patients with malignant phyllodes tumors die of the disease.

Do phyllodes tumors make you tired?

Phyllodes tumor has more consequences than you think. The survival of Phyllodes tumor is great and then live with fatigue.

What is the difference between fibroadenoma and phyllodes tumor?

Fibroadenomas grow up to 2-3 cm and then stop growing but phyllodes tumors grow continually and sometimes are to 40 cm big. Both these lesions have two components, epithelial and stromal. Clinically fibroadenomas are well circumscibed, hard, oval, movable lesions.

Do phyllodes tumors keep growing?

Phyllodes tumors can grow quickly, but they do not always spread beyond the breast. Although many of these tumors are benign, a doctor may recommend surgery to reduce the risk of further growth.

How big are phyllodes tumors?

The median size of phyllodes tumors is around 4 cm. 20% of tumors grow larger than 10 cm (giant phyllodes tumor). These tumors can reach sizes up to 40 cm in diameter (see Figure 1).

How are phyllodes tumors treated?

Tumor Excision and Mastectomy Complete excision, with accurate histologic examination and continued follow-up care, is the best way to treat phyllodes tumors. A general surgery specialist should be consulted. In most cases, wide local excision is indicated, with a rim of normal tissue included.

Can phyllodes tumor cause death?

Symptoms of metastatic involvement can arise from as early as a few months to as late as 12 years after initial therapy. Most patients with metastases die within 3 years of initial treatment. No cures for systemic metastases exist. Roughly 30% of patients with malignant phyllodes tumors die of the disease.

What is the difference between fibroadenoma and phyllodes tumor?

Fibroadenomas grow up to 2-3 cm and then stop growing but phyllodes tumors grow continually and sometimes are to 40 cm big. Both these lesions have two components, epithelial and stromal. Clinically fibroadenomas are well circumscibed, hard, oval, movable lesions.

Do phyllodes tumors metastasize?

Although most phyllodes tumors are benign, malignant cases do uncommonly occur, 22% of which have distant metastasis typically to the lungs and bones. Rarely, this tumor metastasizes to other locations.

Do phyllodes tumors make you tired?

Phyllodes tumor has more consequences than you think. The survival of Phyllodes tumor is great and then live with fatigue.

How long does it take for benign phyllodes to recur?

Benign phyllodes tumors are less likely to recur than malignant ones. The doctor will monitor for recurrence, usually within 1–2 years after removal.

What type of biopsy is used to determine if a tumor is phyllodes?

These tests provide confirmation of the type of tumor. A doctor may recommend a core needle biopsy or an excisional biopsy. A core needle biopsy involves the doctor taking a sample through the skin, using a hollow needle. This may not provide enough evidence that the mass is a phyllodes tumor.

What is a phyllodes tumor?

Phyllodes tumors are a rare type of breast tumor. The pattern of their cells resembles leaves, and the name “phyllodes” comes from the Greek word meaning “leaf-like.”. Phyllodes tumors can grow quickly, but they do not always spread beyond the breast. Authors of a 2013 review note that 35–64%. Trusted Source.

How old do phyllodes tumors develop?

Phyllodes tumors can form at any age, but they tend to affect women aged 35–55 years. Trusted Source. . Those that develop in younger women are more likely to be benign. Very rarely, phyllodes tumors develop in males. Trusted Source. , usually in those with a condition called gynecomastia.

What is an excisional biopsy?

An excisional biopsy involves a surgeon removing the whole tumor for testing. Examining the whole tumor can lead to a more accurate diagnosis.

How many phyllodes are benign?

Authors of a 2013 review note that 35–64% of phyllodes tumors are benign, with the rest being borderline or malignant. According to the American Cancer Society, around 25% are malignant.

Why is my breast blue?

It can become visible as it pushes against the skin of the breast, and it may expand the veins under the skin, causing that area of the breast to appear blue. The tumor may cause an ulcer to form on the skin of the breast, but this is rare. An ulcer can form whether the tumor is benign, borderline, or malignant. .

What Are Phyllodes Tumors?

Phyllodes tumors are a rare type of breast growth. Less than 1% of all breast tumors are this type. Most are not cancer, called benign. But about 25% of these tumors are cancerous (or malignant). Some are borderline, a mix of benign and cancerous.

How long after breast surgery can you get a phyllodes tumor?

Follow-up treatment. Because phyllodes tumors can return, you need careful follow-up after your surgery. Within 4 to 6 months of your surgery, see your doctor for a breast exam, mammogram, and ultrasound.

How to treat a benign phyllodes tumor?

Phyllodes Tumor Treatment. All phyllodes tumors, even benign ones, require surgery. If your tumor is malignant, you may need more aggressive surgery and other treatment. Surgery. There are a few options: Wide excision surgery removes the phyllodes tumor along with some of the healthy breast tissue around it.

What is the procedure to remove a tumor?

Excisional biopsy or lump removal. Most people need this procedure to get a diagnosis. Your surgeon will remove the whole lump and examine the tissue. This biopsy can show if your tumor is benign, borderline cancer, or malignant.

How long after phyllodes surgery do you need a CT scan?

If your phyllodes tumor was malignant, you may need regular CT scans of your chest and abdomen for 5 years after your surgery. Your outlook is excellent if you had a benign tumor removed with surgery. Treatment often cures malignant phyllodes tumors, but they’re more likely to grow back.

What does a mammogram show?

Mammogram. Your doctor may suspect a phyllodes tumor because of something they see on a regular mammogram or ultrasound. It will show detailed images of the lump. A phyllodes tumor has a clearly defined round or oval shape.

What is the best way to find out if a lump is round?

Ultrasound. This test uses sound waves to show pictures inside your body. The doctor will use it to see if the lump is clearly defined and round.

What is a benign breast tumor called?

They may look very much like common benign breast tumors called fibroadenomas. Often, the pathologist needs to look at the whole tumor under the microscope to make a diagnosis. This is why surgery to remove a phyllodes tumor is recommended, even if it is thought to be benign.

What is the treatment for a malignant phyllodes tumor?

Systemic therapy (chemotherapy) may be used if a malignant phyllodes tumor has spread outside of the breast, though this not common. Your oncology team will recommend a treatment plan based on what is known about malignant phyllodes tumors in general and specifically tailored to your disease.

What is the best treatment for phyllodes cancer?

Only if the cancer is known to have spread to other parts of the body will systemic therapy be recommended. Local therapy is aimed at preventing the tumor from coming back in the breast. Local therapy for a phyllodes tumor will include surgery (wide excision or mastectomy) to remove the tumor and extra tissue around it.

Why are phyllodes tumors called leaf tumors?

Their unusual name comes from the Greek word for “leaf”, because they have a leaf-like appearance under the microscope. Some inherited genetic disorders are known to increase the risk of developing a phyllodes tumor, but in most cases, the cause is unknown.

Where do phyllodes start?

Unlike breast cancer which begins in the milk ducts, malignant phyllodes tumors begin in the connective tissue that surrounds and supports the ducts and lobules of the breast. Phyllodes tumors contain different kinds of cells, but the cancerous part is a sarcoma, or cancer of connective tissue. These tumor cells are very different ...

Can phyllodes be treated?

Treatment of malignant phyllodes tumors is also somewhat different than that of more common kinds of breast cancer. Phyllodes tumors that are only in the breast, whether benign or malignant, are most often treated with local therapy alone. Only if the cancer is known to have spread to other parts of the body will systemic therapy be recommended .

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What is the most common manifestation of phyllodes tumor?

On ultrasound, an inhomogeneous, solid-appearing mass is the most common manifestation. A solid mass containing single or multiple, round or cleft like cystic spaces and demonstrating posterior acoustic enhancement strongly suggests the diagnosis of phyllodes tumor.

What is a phyllodes tumor?

Phyllodes tumor, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumor of the breast which has some resemblance to a fibroadenoma. It is typically a large, fast growing mass that forms from the periductal stroma of the breast. On this page:

How common is phyllodes tumor?

The occurrence is most common between the ages of 40 and 60, before the menopause (peak incidence ~45 years). This is about 15 years older than the typical age of patients with fibroadenoma.

Where did the name phyllodes come from?

The name is derived from the Greek word: "phullon" meaning "leaf" . Phyllodes tumors were first described in 1838 by Johannes Muller as "cystosarcoma phyllodes".

Can phyllodes tumors recur?

Both benign and malignant phyllodes tumors have a tendency to recur if not widely excised. Malignant degeneration is seen in 5-25% 4 ( malignant phyllodes tumor ). After wide local excision, there is relatively frequent local recurrence (up to 25%) and up to 10% can metastasize. The mode of metastases in such cases is by hematogenous route.

Can fibroadenomas be seen on ultrasound?

In practice, most lesions are indistinguishable from fibroadenomas on both mammography and ultrasound. This is why interval enlargement of a "fibroadenoma" is seen as an indication for a needle biopsy. Large lesions (i.e. >4 cm) may qualify for excision out of hand because needle biopsy may not be representative of the pathology in the whole lesion.

Can tumors be large?

The tumors can be quite large at presentation.

What is a malignant phyllodes tumor?

Malignant phyllodes tumors are different from the more common types of breast cancer. They are less likely to respond to some of the treatments commonly used for breast cancer, such as hormone therapy or the chemotherapy drugs normally used for breast cancer. Phyllodes tumors that have spread to other parts of the body are often treated more like ...

How do phyllodes tumors affect your risk for breast cancer?

Having a benign phyllodes tumor does not affect your breast cancer risk, but you may be watched more closely and get regular imaging tests, because these tumors can come back after surgery.

How to tell if a tumor is fibroadenomas?

The tumors are usually felt as a painless breast lump, but some may hurt. They tend to grow quickly and stretch the skin. Sometimes they are seen first on an imaging test (like an ultrasound or mammogram ), in which case they’re often hard to tell apart from fibroadenomas . The diagnosis can often be made with a core needle biopsy, but sometimes the entire tumor needs to be removed (during an excisional biopsy) to know for sure that it’s a phyllodes tumor, and whether it's malignant or not.

What is a fill odes tumor?

Phyllodes Tumors of the Breast. Phyllodes tumors (FILL-odes or full-OH-deez) can also be spelled phylloides tumors (full-OY-deez). These are rare breast tumors that start in the connective (stromal) tissue of the breast. Phyllodes tumors are most common in women in their 40s, but women of any age can have them.

Can a woman have a phyllodes tumor?

Phyllodes tumors are most common in women in their 40s, but women of any age can have them. Women with Li-Fraumeni syndrome (a rare, inherited genetic condition) have an increased risk for phyllodes tumors. Most phyllodes tumors are benign (not cancer), but about 1 out of 4 of these tumors are malignant (cancer).

Can a phyllodes tumor come back?

Phyllodes tumors can sometimes come back in the same place if they’re removed without taking enough of the normal tissue around them. For this reason, a margin of normal breast tissue around the tumor is taken out as well.

How do tumour cells travel to lymph nodes?

Tumour cells can travel from the tumour to a lymph node through lymphatic channels located in and around the tumour. The movement of tumour cells from the tumour to a lymph node is called metastasis. Tumour cells from malignant phyllodes tumours may spread to a lymph node.

What is malignant phyllodes?

Malignant. A malignant phyllodes tumour is considered a type of cancer. When examined under the microscope, this type of tumour has many features that are typically seen in cancer including: An increased number of tumour cells (see Stromal cellularity below).

What is borderline phyllodes?

Borderline. When examined under the microscope, a borderline phyllodes tumour has features that can be seen in both non-cancerous tumours and cancers. For this reason, a borderline tumour falls in between benign and malignant. Treatment for this type of tumour depends on the number of worrisome features seen.

What are the different types of phyllodes?

Types of phyllodes tumours – Benign, borderline, and malignant. Pathologists divide phyllodes tumours into three types – benign, borderline, and malignant – based on the way the tumour looks when examined under the microscope. The type of tumour will help your doctor predict how the tumour will behave over time and select treatment options ...

What is atypical cancer?

Atypia is a word pathologists use to describe cells that look different from normal, healthy cells in that same location. Pathologists look at the size, shape, and colour of the cells to decide if they are atypical. The cells in a benign phyllodes tumour are like those found in normal, healthy breast tissue.

How do you know if you have a phyllodes tumour?

Phyllodes tumours usually present as a round, painless lump that you or your doctor can feel during an examination of the breasts. These tumours tend to grow quickly which may cause the skin on top of the tumour to stretch. Most tumours measure several centimetres by the time they are removed.

What is the surgical margin for phyllodes?

A surgical margin is any tissue that was cut by the surgeon to remove the tumour from your body. Whenever possible, surgeons will try to cut tissue outside of the tumour to reduce the risk that any tumour cells will be left behind after the tumor is removed. For phyllodes tumour it is recommended that a surgical margin of at least 1 cm be present around the entire tumour to reduce the chance of recurrence.

Fibroepithelial tumors

Cite this page: Li JJX, Tse GM. Phyllodes tumor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/breastphyllodesgeneral.html. Accessed February 20th, 2022.

Phyllodes tumor

Cite this page: Li JJX, Tse GM. Phyllodes tumor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/breastphyllodesgeneral.html. Accessed February 20th, 2022.

Epidemiology

Clinical Presentation

Pathology

Radiographic Features

• The tumors can be quite large at presentation. Imaging alone is not adequate to differentiate phyllodes tumor from fibroadenoma 13. Phyllodes tumor are frequently classified as BI-RADS 4 tumor 14. Typically seen as non-specific large rounded oval or lobulated, generally well-circumscribed, lesions with smooth margins. A radiolucent halo may be pres...

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Treatment and Prognosis

History and Etymology

Differential Diagnosis