Approaches to phyllodes tumour of the breast: a review article

Firdaus Hayati; Ho Hui Lian; Nornazirah Azizan; Aishath Aznan Ali; Zainal Adwin Zainal Abidin; Muhamad Aznan Suhaili

doi:10.18203/2349-2902.isj20170841

Authors

Firdaus Hayati Department of Surgery, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
Ho Hui Lian Department of Surgery, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
Nornazirah Azizan Department of Pathobiology and Medical Diagnostic, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
Aishath Aznan Ali Department of Surgery, Hospital Canselor Tuanku Muhriz, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Zainal Adwin Zainal Abidin Department of General Surgery, Surgical Sciences Cluster, Faculty of Medicine, University Teknologi MARA, Selangor, Malaysia
Muhamad Aznan Suhaili Department of Surgery, Hospital Canselor Tuanku Muhriz, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia

DOI:

https://doi.org/10.18203/2349-2902.isj20170841

Keywords:

Cystosarcoma phyllodes, Fibroadenoma, Phyllodes tumours, Pseudopod, Triple assessment

Abstract

Phyllodes tumours are rare entities of fibroepithelial diseases. The exact pathogenesis and their relationship with fibroadenomas are oblivious. Women aged between 35 to 55 years are commonly affected, even younger in Asian population. Triple assessment should be applied as a guide to management in any breast pathology. Clinical appearances are typically diagnostic for phyllodes tumours. Even though sometimes inconclusive, mammography and ultrasonography are the main imaging modalities. Although the role of cytology is debatable, presence of both epithelial and stromal elements supports the diagnosis especially in malignant type. Core biopsy is rather favored in view of higher accuracy for the diagnosis. Accurate preoperative assessment and histologic diagnosis allow correct surgical intervention and subsequent avoidance of reoperation. Surgical management can be either wide excision with more than 1 cm margins or mastectomy without axillary surgery. Local recurrence has been associated with inadequate excision of the pseudopod. Adjuvant radiotherapy is recommended for positive surgical margin and for local control of borderline and malignant phyllodes tumors. The role of chemotherapy and endocrine therapy has not been fully studied.

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