Underwent left mastectomy. Breast sent for pathology:

Malignant phylloides tumor, maximal diameter is 15 cm. Skin, nipple and resection margins are free. Minimal distance to inked margins is 0.25 mm. Lymphovascular invasion not seen.

Immunostains:
P53 and C- kit (in few cells) positive. PAN-CK, P63, P40, β-catenin and CD34 negative. Ki67 is high, up to 80%.

She was started on the IFOS chemotherapy protocol. CT chest before commencing radiotherapy showed new nodules in the lower lobes. A chest x-ray below, taken 2 months later due to neutropenic fever, does not show any focal pathology:

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