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Phyllodes Tumors

Phyllodes tumors of the breast, which are very rare, account for only less than 1% of all diagnosed cases of breast tumors. These tumors usually develop in the connective tissues of the breast forming a hard lump, and generally grow very rapidly although they hardly spread beyond the breasts.

Phyllodes tumors of the breast are mostly common among women in their 40s and 50s who haven’t gone through menopause yet; but they can occur at any age in a woman’s lifetime. The tumors can be:

  1. Malignant (cancerous)
  2. Benign (non-cancerous)
  3. Borderline (in between cancerous and non-cancerous)

Symptoms of Phyllodes Tumors of the Breast

Most common symptom of Phyllodes tumors of the breast is usually a lump that can be felt during a breast exam.

Some of the symptoms of Phyllodes tumors of the breast, whether malignant, benign or borderline include:

  • Breast lump that is smooth and hard to the touch
  • Bulging under the skin
  • Fast-growing lump (reaches about 2-3cm in a matter of weeks)
  • An ulcer on the breast in advanced Phyllodes tumors of the breast cases

Diagnosis of Phyllodes Tumors of the breast

Phyllodes tumors of the breast is diagnosed during a routine breast exam, either by yourself or a doctor. They can be challenging to diagnose because they can easily be confused with other types of breast cancers, which are mostly malignant, especially a non-cancerous breast condition known as fibroadenoma. In order to confirm the presence of breast cancer, you will be referred to a breast specialist for a range of tests which include:

  1. An ultrasound scan
  2. Mammogram
  3. Core Biopsy where a tissue sample is removed from breast for analysis
  4. MRI Scan where radio waves and magnetism are used to produce images of the tumor inside the breast.

Treatment of Phyllodes Tumors of the breast

Based on the test results of the Phyllodes tumors of the breast, the breast doctor will customize the treatment plan according to the features of the breast cancer. This treatment plan is dependent on certain criterion including:

  • The aggressiveness of the cancer
  • Whether the cancer is benign, malignant or borderline
  • Grade of the cancer
  • Tumor size and location
  • Age and overall health
  • History of breast cancer in the family
  • Gene mutation test results

Surgery

The first form of treatment for benign, malignant and borderline Phyllodes tumors of the breast is surgery, which is used to remove the tumor. There are two major types of surgeries that are done. These are:

1.      Breast-conserving surgery (BCS)

Also known as a lumpectomy, the surgeon removes the lump/cancer cells, as well as a minimal amount of healthy breast tissue surrounding the tumor.

2.      Mastectomy

This is the surgical removal of the entire breast including the nipple, and it would be recommended if:

  1. The area of the cancer is large
  2. The cancer cells are in multiple areas of the breast
  3. There is a gene mutation which increases the likelihood of breast cancer
  4. There’s a history of breast cancer in the family
  5. The patient cannot stand radiation

Before a full mastectomy, the patient is always given the option of having breast reconstruction. This can happen immediately (immediate breast reconstruction) after the tumor is removed, or at a later date (delayed breast reconstruction). After a mastectomy, some women may be unable to have a breast reconstruction procedure, at which point a prosthesis breast is recommended.

Additional treatments for Phyllodes Tumors of the breast

After a lumpectomy or mastectomy, you may need additional treatments for Phyllodes tumors of the breast, also known as adjuvant treatments. The goal is to give the best promising outcome, and to reduce the chances of the cancer returning. Each treatment recommended depends on the state of the breast cancer and differs from one case to the next. These treatments include:

  • Radiation therapy: If you go through a lumpectomy, you may need radiation therapy to destroy any cancer cells and reduce the chances of it recurring on the same breast. This is especially important because benign Phyllodes tumors of the breast can sometimes come back. The chemotherapy might be done for the chest wall as well, if the lymph nodes under the arm are also affected by the cancer.
  • Chemotherapy: If the Phyllodes tumors of the breast has spread beyond the breasts, which have a likelihood of doing if they are malignant, then the patient is offered the option of undergoing chemotherapy. Chemotherapy is an anti-cancer drug therapy that is done before surgery to reduce the size of the tumor with the aim of making it operable. The treatment is also given after surgery to minimize the chances of the cancer spreading or returning. Its recommendation depends on different factors such as the grade and size of the tumor, estrogen receptor (ER) status, and human epidermal growth factor receptor 2 (HER2) status.

Recovery after Phyllodes Tumors of the breast

After the successful treatment of Phyllodes tumors of the breast, your doctor will keep a close watch on you. And although in borderline and malignant Phyllodes tumors have very minimal risk of returning, they still can, a risk which is higher with the malignant ones. Follow-up appointments are required and should be followed as agreed with the breast doctor, where he/she will do tests for signs of recurrence. A mammogram and screening might be required every 6 to 12 months.

Next Steps

At King’s College Hospital London Dubai, our Breast Care Clinic caters to every type of breast cancer and breast conditions. If you are facing any kind of abnormal changes to your breast, regardless how small, get in touch for a consultation with one of our breast doctors. For more information on breast cancer and breast care, book an appointment below.

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