Phyllodes tumours

Phyllodes tumours are rare breast tumours. Most phyllodes tumours are non-cancerous (benign). They are made of a mixture of cells from connective (fibrous) tissue and the tissue layer lining the breast (the epithelium).

The 3 main types of phyllodes tumour are:

• benign (non-cancerous)
• borderline (between benign and cancerous)
• cancerous (malignant).

In a borderline tumour, the cells are more abnormal than in a benign tumour. But the cells are not as abnormal as they are in a malignant tumour.

Treatment will cure most benign and borderline tumours. Malignant tumours may also be cured with treatment.

Phyllodes tumours usually only affect 1 breast. Sometimes they affect both breasts. It is uncommon for phyllodes tumours to spread to other parts of the body.

Doctors do not know the exact cause of phyllodes tumours. They can affect people of any age. But they are more common before the menopause, in people aged between 40 and 50.

Surgery is the main treatment for phyllodes tumours. It is usually the only treatment you need.

Rarely, phyllodes tumour can be malignant and may have spread to other areas. In this case, you may need further treatment, such as radiotherapy. Your cancer doctor will talk to you about what type of treatment you will have.

Hormonal therapy is often used to treat breast cancer. But it is not used for phyllodes tumours. This is because research shows it has no effect on them.

You will usually have an operation to remove the lump and some surrounding healthy tissue. This is called breast-conserving surgery. It is sometimes called a lumpectomy or wide local excision (WLE).

After your operation, a doctor called a pathologist looks at the tissue that was removed under a microscope. If there are tumour cells at the outer edge of the surrounding healthy tissue, your surgeon will usually recommend another operation. They will usually remove more tissue from the same area. This reduces the risk of any tumour cells being left behind and the tumour growing back.

If the lump is large compared to the size of the breast, the surgeon may advise removing the whole breast. This is called a mastectomy.

If you need a mastectomy, your surgeon may talk to you about options for breast reconstruction. This is when a new breast shape is made. Some people have breast reconstruction at the same time as a mastectomy. But if you have a mastectomy for a phyllodes tumour, your surgeon will usually offer you reconstruction at a later time. They can talk to you about what type of reconstruction might be suitable for you.

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells.

Chemotherapy is rarely used to treat phyllodes tumours. It is only used if the phyllodes tumour is malignant and has spread to another part of the body.

The drugs used to treat malignant phyllodes tumours are the same as those used to treat soft tissue sarcoma. This is because the cells that are abnormal in phyllodes tumours are the same as the cells that are abnormal in soft tissue sarcomas.

You usually have chemotherapy into a vein as an injection or a drip (infusion). Treatment usually lasts 4 to 6 months. You may have a combination of 2 or more chemotherapy drugs.

Radiotherapy uses high-energy x-rays to treat cancer cells. If you have a malignant phyllodes tumour, your cancer doctor may recommend having radiotherapy after surgery. This can help to reduce the risk of the cancer coming back.

Your cancer doctor may talk to you about having treatment as part of a clinical trial. Clinical trials test new treatments or different combinations of treatment.

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