Phyllodes Tumors of the Breast
Phyllodes tumors (FILL-odes or full-OH-deez) can also be spelled phylloides tumors (full-OY-deez). These are rare breast tumors that start in the connective (stromal) tissue of the breast.
Phyllodes tumors are most common in women in their 30s and 40s, but women of any age can have them. Women with Li-Fraumeni syndrome (a rare, inherited genetic condition) have an increased risk for phyllodes tumors.
Most phyllodes tumors are benign (not cancer), but about 1 out of 10 of these tumors are malignant (cancer).
The tumors are usually felt as a painless lump, but some may hurt. They tend to grow quickly and stretch the skin. They’re often hard to tell from fibroadenomas on imaging tests (like an ultrasound or mammogram), or even with certain types of needle biopsies. In most cases, the entire tumor needs to be removed (during an excisional biopsy) to know for sure that it’s a phyllodes tumor that’s not cancer.
Breast-conserving surgery is the main treatment. Phyllodes tumors can sometimes come back in the same place if they’re removed without taking enough of the normal tissue around them. For this reason, they’re treated by taking out the tumor and at least a 1 cm (a little less than ½ inch) margin of normal breast tissue around the tumor. Mastectomy may be needed if a cancer-free margin of normal breast tissue cannot be taken out with the tumor.
Phyllodes tumors that are cancer are treated by removing them along with a wider area of normal tissue, or by removing the entire breast (mastectomy). Malignant phyllodes tumors are different from the more common types of breast cancer. They don’t respond to hormone therapy and are less likely than most breast cancers to respond to radiation therapy or the chemotherapy drugs normally used for breast cancer. Phyllodes tumors that have spread to other parts of the body are often treated more like sarcomas (soft-tissue cancers) than breast cancers.
Because these tumors can come back, close follow-up with frequent breast exams and imaging tests are usually recommended after treatment.
How do phyllodes tumors affect your risk for breast cancer?
Having a phyllodes tumor that’s not cancer does not affect your breast cancer risk, but you may be watched more closely and get regular imaging tests, because these tumors can come back after surgery.1
Calhoun KE, Lawton TJ, Kim JN, Lehman CD, Anderson BO. Phyllodes tumors. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds. Diseases of the Breast. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2010:781-792.
Guray M, Sahin AA. Benign breast diseases: Classification, diagnosis, and management. Oncologist. 2006;11;435-449.
Hartmann LC, Sellers TA, Frost MH, et al. Benign breast disease and the risk of breast cancer. N Engl J Med. 2005;353:229-237.
1 Moutte A, Chopin N, Faure C, et al. Surgical Management of Benign and Borderline Phyllodes Tumors of the Breast. Breast J. 2016 Jun 6. doi: 10.1111/tbj.12623. [Epub ahead of print]
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Breast Cancer. Version 2.2016. Accessed at www.nccn.org/professionals/physician_gls/f_guidelines.asp on June 10, 2016.
Santen RJ, Mansel R. Benign breast disorders. N Engl J Med. 2005;353:275-285.
Schnitt SJ, Collins LC. Pathology of benign breast disorders. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds. Diseases of the Breast. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2010:69-85.
Last Medical Review: March 16, 2015 Last Revised: April 21, 2016
- Fibrosis and Simple Cysts in the Breast
- Hyperplasia of the Breast (Ductal or Lobular)
- Lobular Carcinoma in Situ (LCIS)
- Adenosis of the Breast
- Fibroadenomas of the Breast
- Phyllodes Tumors of the Breast
- Intraductal Papillomas
- Granular Cell Tumors of the Breast
- Fat Necrosis and Oil Cysts in the Breast
- Duct Ectasia
- Other Non-cancerous Breast Conditions