1.1 What is phylloides tumour?
Phyllodes Tumor is a very rare type of breast tumor, accounting for only about one percent of all breast tumors. Phyllodes tumors can be further classified into three categories based on their pathological appearance under a microscope: benign, malignant, and the intermediate category known as “borderline” tumors. The majority of phyllodes tumors are benign.
Phyllodes tumors have both stromal and epithelial components. When the stromal component excessively proliferates and compresses the epithelial component, it appears as leaf-like structures under microscopic examination, hence the name “phyllodes” tumor.
1.2 Symptoms of phylloides tumour
Patients with phyllodes tumors are primarily women in their forties to fifties. They may discover a painless lump in the breast, which grows rapidly and compresses the surrounding normal breast tissue, leading to breast deformation. The skin over the tumor may also develop ulceration due to the compression. In some cases, the tumor can grow to be over 20 centimeters in size by the time the patient seeks medical attention.
Benign phyllodes tumors do not metastasize, but the chances of metastasis for borderline and malignant phyllodes tumors are approximately 4% and 22%, respectively. The tumor typically spreads through the bloodstream to distant organs such as the lungs, bones, and liver. Metastasis can cause symptoms such as pleural effusion, difficulty breathing, liver dysfunction, and bone pain in patients.
1.3 Cause of phylloides tumour
The exact cause of phyllodes tumors in the breast is currently unknown.
1.4 Diagnosis of phylloides tumour
If you discover a lump, it is important to consult a doctor for an accurate diagnosis and to develop an appropriate treatment plan. Doctors generally recommend a Triple Assessment for diagnosis, which includes:
Clinical examination
The doctor will inquire about your medical history, family history, and symptoms, and then perform a clinical examination. During the examination, the doctor will note and record information such as the size, location, and characteristics of the breast lump.
Imaging studies
Imaging studies may include mammography and ultrasound. These tests not only show the location and size of the lump but also reveal features such as calcifications, lymph nodes in the armpit, and the uniformity of echoes. Additionally, imaging studies can help detect any other lesions in both breasts that may have gone unnoticed.
Pathological examination
In most cases, doctors will arrange for a core needle biopsy, where a sample of tissue is extracted from the lump and examined under a microscope in detail to determine its nature and provide a final pathological diagnosis.
After undergoing the Triple Assessment, the doctor will obtain an accurate diagnosis, enabling them to develop an appropriate treatment plan for the patient.
1.5 Management of phylloides tumour
Due to the rapid growth of phyllodes tumors, doctors typically recommend surgical removal. During the surgery, the doctor will remove the tumor along with a margin of one to two centimeters of surrounding tissue to ensure complete removal. This method is known as wide local excision. If the tumor is too large, the doctor may need to perform a total mastectomy, which involves the complete removal of the breast. Since phyllodes tumors do not typically spread to the lymph nodes, lymph node removal is generally not necessary during surgery.
Chemotherapy and radiation therapy have limited effectiveness in treating phyllodes tumors.