Phylloides tumour of the breast: Diagnostic and therapeutic problems

Phyllodes tumour (PT) is a rare breast tumor with mixed connectival and epithelial components, which usully relapses topically after excision. Five patients with PT took part in the study (4 were positive for benigne PT and one was positive for malignant PT at extemporary histological examination). The patients (3) with 3 cm or minus benigne lesion had mass excision with a large resection of the surrounding mammary tissue. In the remaning patient with benigne neoplasm (8 cm lesion) simple mastectomy was carried out. Finally the patient with malignant PT (5 cm lesion) underwent a simple mastectomy without following chemotherapy or radiotherapy. Follow-up (at 6 and 12 months) consisted of mammography and clinical examination. One out of the 3 patients treated with large resection had a local relapse which was then treated surgically. There was no evidence of relapse at 12 months in the remaning patients with benign tumor. The patient with malignant PT returned to our attention with multiple bone metastases in the toracic lumbare tract two years later. She received multiple courses of combined radiotherapy and chemoterapy. Local relapses do not appear to affect survival: as a consequence, wide excision should be the primary treatment of benign phyllodes tumors. Total mastectomy has been indicated for malignant phyllodes tumors and for very large tumors.