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Phyllodes tumors of the breast

Authors
Ana M Grau, MD, FACS
A Bapsi Chakravarthy, MD, FASTRO
Rashmi Chugh, MD
Section Editors
Lori J Pierce, MD
Daniel F Hayes, MD
Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
Deputy Editor
Wenliang Chen, MD, PhD

INTRODUCTION

Phyllodes tumors are uncommon fibroepithelial breast tumors that are capable of a diverse range of biologic behaviors. In their least aggressive form, phyllodes tumors behave like benign fibroadenomas, although with a propensity to recur locally following excision without wide margins. At the other end of the spectrum, other phyllodes tumors can metastasize distantly, sometimes degenerating histologically into sarcomatous lesions that lack an epithelial component [1,2].

The term "phyllodes," which means leaf-like, describes the typical papillary projections that are seen on pathologic examination. Although they were originally called "cystosarcoma phyllodes" by Johannes Müller in 1838 [2], phyllodes tumors only occasionally have cystic components and are not true sarcomas by either cellular origin or biologic behavior. The terminology has since evolved, with over 60 synonyms having been applied to this entity before the term "phyllodes tumors" was adopted by the World Health Organization [3,4].

The clinical presentation, diagnosis, treatment, and prognosis of breast phyllodes tumors are discussed in this topic. Other benign (eg, fibroadenoma) or malignant lesions of the breast are discussed elsewhere. (See "Overview of benign breast disease" and "Clinical features, diagnosis, and staging of newly diagnosed breast cancer" and "Overview of the treatment of newly diagnosed, non-metastatic breast cancer".)

EPIDEMIOLOGY AND RISK FACTORS

Phyllodes tumors account for less than 1 percent of all breast neoplasms [4,5]. Given their rarity, epidemiologic data are scant. In a study from Los Angeles county over a 17-year period, the average annual incidence rate of malignant phyllodes tumors was 2.1 per million women, and the incidence was higher in Latina whites than in non-Latina whites, Asians, and African Americans [6].

The vast majority of phyllodes tumors occur in women, with a median age of presentation of 42 to 45 years (range 10 to 82 years) [3,6-8]. Higher-grade tumors are more common in older patients [9]. In men, phyllodes tumors usually occur in association with gynecomastia [3].

                            
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Literature review current through: Nov 2017. | This topic last updated: Jun 06, 2017.
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