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Borderline malignant and malignant phyllodes tumours

Phyllodes tumours are smooth, hard lumps of tissue that grow in the stroma (supportive tissue) of the breast. Once formed a phyllodes tumour may grow quite large, quite quickly.

Phyllodes tumours are grouped into three types:

The information on this webpage is about borderline malignant and malignant phyllodes tumours, but phyllodes tumours can also be benign. Find out more about benign phyllodes tumours.

Borderline malignant and malignant phyllodes tumours are rare types of breast cancer. They may be difficult to diagnose because they can be confused with other breast problems such as a fibroadenoma.

Although they can affect people at any age, phyllodes tumours are most common in women between 40 and 50 who haven’t yet been through the menopause.

Diagnosis

Your GP is likely to refer you to a breast clinic where you’ll have a range of tests to help make a diagnosis. You may also have a magnetic resonance imaging (MRI) scan. This scan uses magnetism and radio waves to produce a series of cross sectional images of the inside of the breast.

Sometimes you may need an operation to remove the lump to get a definite diagnosis.

Treatment

Surgery

Phyllodes tumours are always treated with surgery. You'll be offered breast-conserving surgery or a mastectomy, with or without breast reconstruction.

Breast-conserving surgery, usually referred to as wide local excision or lumpectomy, is the removal of the tumour with a margin (border) of normal breast tissue around it (known as a clear margin). A mastectomy is the removal of all the breast tissue including the nipple.

You may be given a choice between these two types of surgery. If a wide local excision is possible, then it's important that a clear margin of tissue is taken from around the tumour. If a clear margin of tissue is not seen when the area removed is examined under the microscope, then a second operation might be needed.

Unlike other types of breast cancer, borderline malignant and malignant phyllodes tumours rarely spread to the lymph nodes under the arm (axilla) so these will not be routinely removed during surgery. However, your surgeon will look at your individual case and recommend the best surgery for you.

Adjuvant (additional) treatment

If you have a borderline malignant phyllodes tumour you will not need any additional treatments after surgery.

If you have a malignant phyllodes tumour, you won’t usually need any other treatment such as radiotherapy and chemotherapy. However, your surgeon may want you to see an oncologist (a doctor who specialises in the treatment of cancer) to discuss your situation.

Hormone (endocrine) therapies that are sometimes used in breast cancer are not used to treat malignant phyllodes tumours.

Can it come back or spread?

In most cases, a borderline malignant or malignant phyllodes tumour is successfully treated by surgery. But sometimes the tumour can recur in the breast (known as local recurrence). If this happens, more surgery will usually be offered.

Radiotherapy may also be offered either alone or after surgery.

A malignant phyllodes tumour can spread (metastasise) through the bloodstream to other parts of the body, although in the vast majority of cases this does not happen. If a malignant phyllodes tumour does spread, you will be seen by an oncologist, who will assess your case and recommend the best treatment for you.

Follow-up

Your follow-up care after treatment for a borderline malignant or malignant phyllodes tumour will vary depending on the hospital where you are being treated. Your individual situation and the hospital’s policies will both play a part. It’s usually recommended that you have a yearly follow-up appointment and a mammogram (after a mastectomy this will be done on the other breast).

You will be given information about who to contact in case you have concerns in between follow-up appointments or develop any new symptoms.

 

Last reviewed April 2014; next planned review 2016

Last edited:

30 April 2014