Malignant phyllodes tumor

Last revised by Dr Ammar Ashraf on 07 May 2021

Malignant phyllodes tumor of the breast accounts for up to a quarter of the phyllodes tumors.

Please, refer to the main article on phyllodes tumors for a general discussion. 

It is generally thought that it is the stromal component that becomes malignant 4. This may account for their hematogenous metastatic pattern.

A substantial overlap in the imaging characteristics has been reported between benign and malignant phyllodes tumors. A tumor diameter of 3 cm or greater has been generally reported to be associated with a higher likelihood of malignancy 3.

Fewer than 20% of the malignant tumors metastasize. When metastatic disease does occur, the metastases usually spread hematogenously to the lungs, pleura, or bone. Surgery is the mainstay of treatment as they are not proven to be sensitive to radiotherapy or chemotherapy. Because lymphatic metastasis is rare, axillary nodal surgery is not indicated.

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Cases and figures

  • Case 1: malignant phyllodes tumor
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