What is phyllodes tumor?

• February 3, 2025
• By Fernando Amato

The phyllodes tumor is a rare type of breast tumor that originates in the connective tissue of the breast, known as the stroma. It presents similarly to other breast lumps, such as fibroadenomas, but differs in its nature, which can vary between benign, borderline (intermediate), and malignant. Despite its rarity, it represents an important concern in breast health due to its potential for rapid growth and the chance, though low, of malignancy.

📝 Highlights about phyllodes tumor:

1. 🌿 Originates in the connective tissue of the breast, unlike tumors that arise in the ducts or lobules.

2. 📈 Can be benign, borderline, or malignant, with potential for rapid growth.

3. ⚠️ Rarity: Represents less than 1% of diagnosed breast tumors.

4. 🩺 Generally presents as a rapidly growing lump, causing discomfort or asymmetry.

5. ✅ Treatment usually involves surgery, with mastectomy being necessary in more severe cases.

What causes phyllodes tumor?

The exact cause of phyllodes tumor is not yet fully understood. However, it is believed to be related to genetic alterations in the mammary stromal tissue, which is responsible for supporting and nourishing the mammary ducts. Most cases occur in women between 40 and 50 years old, usually in the postmenopausal period, although it can be found in younger patients.

Known risk factors include:

• History of fibroadenoma (common benign breast tumor);
• Genetic predisposition or family history of breast tumors;
• Hormonal changes associated with reproductive age.

Signs and symptoms of phyllodes tumor

The main symptom of phyllodes tumor is the presence of a breast lump, which usually grows rapidly and can reach considerable sizes in a short time. It is common for these tumors to be painless, but, depending on their location and size, they can cause discomfort or even deformities in the breast.

Other signs include:

• Breast asymmetry due to increased volume;
• Skin changes over the affected area, such as redness or tension;
• Feeling of heaviness in the breast.

However, it is worth noting that phyllodes tumor is not identified by touch alone. Imaging exams, such as ultrasound and mammography, are essential to differentiate it from other types of tumors.

How is the diagnosis made?

The diagnosis of phyllodes tumor begins with a clinical evaluation, in which the doctor examines the breast and gathers information about the patient's medical history. However, due to its similarity to other benign nodules, such as fibroadenoma, complementary exams are necessary:

1. Ultrasound: Generally reveals a solid nodule with well-defined borders, but with accelerated growth.

2. Mammography: Can detect changes in breast tissue and help differentiate between tumors.

3. Biopsy: This is the definitive exam, in which a tissue sample is removed and analyzed under a microscope. The biopsy allows determining whether the tumor is benign, borderline, or malignant.

🔎 Important: Tumor classification is essential for defining treatment and predicting the behavior of the lesion.

Types of phyllodes tumor

Phyllodes tumors are classified as:

• Benign: Local growth, with a low chance of recurrence after removal;
• Borderline: Intermediate behavior, with a higher risk of recurrence after surgery;
• Malignant: Can metastasize (spread to other parts of the body), although this is rare.

Treatment of phyllodes tumor

The standard treatment for phyllodes tumor is surgery. The choice of procedure depends on the size and classification of the tumor:

1. Surgical excision with clear margins: Removal of the tumor with a safe margin of healthy tissue around it. It is the most common approach in benign and borderline cases.

2. Mastectomy: Indicated in cases of large, recurrent (returning after removal), or malignant tumors.

3. Radiotherapy or chemotherapy: Generally not necessary, but may be indicated in malignant cases with a high risk of metastasis.

Note: Regular medical follow-up is essential to monitor for possible recurrences, especially in borderline or malignant tumors.

Prognosis

The prognosis of phyllodes tumor depends on its classification. In benign and borderline cases, surgical treatment generally results in a complete cure. In malignant tumors, strict follow-up is therefore essential to detect any complications, such as metastases.

In general, the earlier the tumor is diagnosed and treated, the better the results for the patient.

When to seek a doctor?

If you notice any lump or change in your breast, it is essential to seek a specialist, especially if the lump:

• Grows rapidly;
• Causes pain or discomfort;
• Leads to breast asymmetry or deformity.

Schedule a consultation with a plastic surgeon or mastologist, such as Dr. Fernando Amato, for a detailed evaluation and access to appropriate treatment.

👉 Do not ignore signs or symptoms! Early diagnosis makes all the difference.

Frequently Asked Questions

1. Is phyllodes tumor always malignant?

No, it can be benign, borderline, or malignant. Most cases are benign.

2. What is the difference between fibroadenoma and phyllodes tumor?

Both are benign breast tumors, but phyllodes tends to grow faster and can be malignant in some cases.

3. Can phyllodes tumor disappear on its own?

No. Surgical treatment is necessary for its removal.

4. Is there a risk of recurrence?

Yes, especially in borderline and malignant cases. Therefore, medical follow-up is essential.

5. Is it possible to prevent phyllodes tumor?

There is no specific prevention, but regular follow-up helps with early diagnosis.

6. Can phyllodes tumor occur in men?

Although very rare, it can occur in exceptional cases, given that men have less breast tissue.

7. Which specialist treats phyllodes tumor?

Plastic surgeons and mastologists are the indicated professionals.

8. How to know if the tumor is malignant before surgery?

Biopsy is the definitive test to determine the nature of the tumor.

9. Can phyllodes tumor spread to other organs?

In malignant cases, there is a small risk of metastasis.

10. Is it necessary to reconstruct the breast after surgery?

In cases of mastectomy, breast reconstruction may be indicated with specific techniques, such as the use of implants (learn more here).

Keywords:

#tumor #phyllodes #breast #surgery #diagnosis

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