Phyllodes tumours

Phyllodes tumours are rare fibroepithelial lesions that account for less th an 1% of all breast neoplasms. With the non-operative management of fibroad enomas widely adopted, the importance of phyllodes tumours today lies in th e need to differentiate them from other benign breast lesions. All breast l umps should be triple assessed and the diagnosis of a phyllodes tumour cons idered in women, particularly over the age of 35 years, who present with a rapidly growing "benign" breast lump. Treatment can be by either wide excis ion or mastectomy provided histologically clear specimen margins are ensure d. Nodal metastases are rare and routine axillary dissection is not recomme nded. Few reliable clinical and histological prognostic factors have been i dentified. Local recurrence occurs in approximately 15% of patients and is more common after incomplete excision. It can usually be controlled by furt her surgery. Repeated local recurrence has been reported without the develo pment of distant metastases or reduced survival. Approximately 20% of patie nts with malignant phyllodes tumours develop distant metastases. Long term survival with distant metastases is rare. The role of chemotherapy, radioth erapy, and hormonal manipulation in both the adjuvant and palliative settin gs remain to be defined.