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PHYLLODES TUMOUR OF THE BREAST


What is Phyllodes tumour of the breast?


Phyllodes tumour of the breast is a tumour which arises from the connective tissue surrounding the ducts and glands of the breast. It usually arises in women in their 40s and may occur later than that.


Is this a benign swelling or a malignant tumour?


Most of the Phyllodes Tumour of the breast are benign in that they are limited to the breast. However, around 10 to 30% of swellings in the breast maybe malignant and there is a chance that it may spread to other areas in the body like the lungs and the brain. The differentiation between a benign swelling and a malignant tumour can only be made with the biopsy result where some predictors of malignancy are used to decide whether the swelling is benign or malignant.


How does the Phyllodes tumour of the breast present?


The Phyllodes tumour of the breast presents as a swelling in the breast which rapidly increases in size regardless of whether it is benign or malignant. If the size of the Phyllodes tumouris very large, it may then erode the skin producing an ulcer. As it does not spread by the lymphatic system, the lymph nodes in the axilla(armpit) or not enlarged.


How is this condition diagnosed?


The Phyllodes tumour of the breast is diagnosed by using a core needle biopsy or an incisional biopsy if there is an ulcer due to a tumour.


How is this condition treated?


The swelling needs to be excised with a wide margin of 1 cm on all sides. Excision of the swelling with a 1 cm margin on all the sides would result in removal of a big portion of the breast resulting in a partialmastectomy or simple mastectomy (Removal of the breast). Breast reconstruction with tissue from the abdomen, thighs or back can be done at the same time or done later. As the tumour does not spread to the axilla, sentinel lymph node biopsy and axillary dissection are not needed. If the biopsy shows the swelling as malignant, radiotherapy is added to prevent recurrence.


What is done if the tumour recurs?


If the tumour recurs, a repeat wide local excision of the tumouris done with a margin of 1 cm. If radiotherapy had not been given previously, it may be given.


What is done if there is distant metastasis?


Distant metastasis is rare and chemotherapy/ radiotherapy maybe tried in some patients