Breast Phyllodes tumors, known as osteosarcoma phyllodes, are rare lumps that can develop in the breast. Invasive micropapillary carcinomas are not frequent and are present in 0.3 to 1 percent of breast tumors. Phyllodes tumors may look like leaves, hence the tongue-twister name from the Greek term for “leaf.” Phyllodes tumors are classified differently; some are nonaggressive (benign), whereas others are aggressive (malignant).
Doctors usually discover these tumors, although sometimes a woman may come into practice or hospital complaining of a firm mass that may be increasing in size in the breast. If the doctor is not sure that the phyllodes tumor is benign, they may order ultrasounds or a biopsy to learn more.
According to the blog “Phyllodes Tumour – Understanding The Rare Breast Tumor,” the primary therapy for denominating these tumors is mastectomy. If the tumor is benign, that can be all that is required, but if the cancer is malignant, further treatment may be necessary to excise it again.
Characteristics of Phyllodes Tumors
Phyllodes tumors are often realized to originate from the breast stroma instead of the ducts and lobules, as with other types of cancer. They are characterized by:
- Growth Pattern: These tumors are known for their rapid growth and can reach impressive sizes, measuring anywhere from less than 1 cm to more than 40 cm in diameter. They are predominantly unilateral and tend to manifest clinically as hard nodules with no associated features of inflammation. They alter the shape of the breast.
- Types: Phyllodes tumors are classified into three types depending on histological appearance.
- Benign: These tumor lesions are usually circumscribed with a low mitotic rate.
- Borderline: Features that are not benign and, at the same time, not malignant.
- Malignant: It has high mitotic activity and stromal overgrowth.
Symptoms and Diagnosis
While any significant change in the size or shape of the breast is a sign of a distorted breast, the most critical indicator of a phyllodes tumor is the presence of a lump in the bust. They also start getting skin changes over the cancer, erythema, or distension of veins, making the breast have a blue hue. Unlike more common breast tumors, which are generally not palpation-ally painful, the tumors described herein may cause a bloody discharge from the nipple due to tumor infarction.
In diagnosing the phyllodes tumor, there are difficulties in distinguishing the tumor from other breast pathologies such as fibroadenomas. Diagnostic methods include:
- Imaging Techniques: On mammography, breast cancer can be described as a shadow of a well-circumscribed mass that is rounded or oval with regular margins. Ultrasound replaces radiography because the latter reveals specific signs, including the nature of internal structure and the clefts filled with liquid.
- Biopsy: CNB is crucial for examining histopathological evidence to make a differential diagnosis between phyllode tumors and other tumor types.
Treatment Options
Surgery to remove the tumor bulk is typically the primary treatment for phyllode tumors. The type of process that will be conducted depends on the extent and positioning of the tumor.
- Excision: This involves removing the neoplasm along with the consecutive normal tissue, which assumes control of the potential return of the tumor.
- Mastectomy: If the tumor is large or situated at the center of the breast, a mastectomy of the breast will be required.
In contrast to most other breast cancers, phyllode tumors are generally not amenable to adjuvant chemotherapy or radiation therapy because of their biology. However, if a malignant tumor has developed a recurrence or metastasized, then the surgical operation may have to be repeated.
Prognosis and Follow-Up
As mentioned before, phyllodes tumors are ranked according to their histological grade, depending on the prognosis of patients with this disease. Benign tumors can be treated effectively with a minimum of around 10% reoccurrence, while malignant ones reoccur at a higher rate of around 40%. Metastasis in malignant phyllode tumors is favored via the hematogenous route more than a lymphatic route to lungs and soft tissues.
Many patients will experience localized recurrences or metastases; consequently, close follow-up is needed to monitor such complications. These patients are usually supervised through physical assessments and imaging tests.
Conclusion
Phyllodes tumors are, therefore, a rare category of breast tumors, and their diagnosis and treatment deserve special consideration. These features indicate that it is still fast-growing and exhibiting diverse behaviors that warrant early surgical management. Although they are often not malignant, comprehending the features and the kinds of therapy accessible is crucial to enhancing the quality of treatment. However, continued study on the biology of these tumors may reveal more about their causes and the best treatment approaches for them in the future.