Malignant phyllodes tumour

Last revised by Yaïr Glick on 17 Apr 2024

Malignant phyllodes tumour of the breast accounts for up to a quarter of the phyllodes tumours.

Please, refer to the main article on phyllodes tumours for a general discussion. 

It is generally thought that it is the stromal component that becomes malignant 4. This may account for their haematogenous metastatic pattern.

A substantial overlap in the imaging characteristics has been reported between benign and malignant phyllodes tumours. A tumour diameter of 3 cm or greater has been generally reported to be associated with a higher likelihood of malignancy 3.

Fewer than 20% of the malignant tumours metastasise. When metastatic disease does occur, the metastases usually spread haematogenously to the lungs, pleura, or bone. Surgery is the mainstay of treatment as they are not proven to be sensitive to radiotherapy or chemotherapy. Because lymphatic metastasis is rare, axillary nodal surgery is not indicated.

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