Cystosarcoma Phyllodes or Phyllodes Tumor.

This tumor is unique to the female breast. It should be clearly differentiated from a JUNEVILE FIBROADENOMA.

• Clinical Presentation:   These tumors can be of any size but are usually diagnosed as a large, rapidly growing, bulky breast tumor (over 5 cm in size). They can occur at any age but is seen mostly in women in their fifties.

• Mammographic Presentation: These tumors have the mammographic appearance of a fibroadenoma.

• Diagnosis: The histological diagnosis is made by excisional biopsy. Most of these tumors are usually benign. However, a few can be malignant. We usually request that our pathologist classifies these tumors as, benign, malignant or borderline Cystosarcoma Phyllodes.

• Treatment: The treatment of these tumors is surgical. As they have a significant rate of local recurrence, surgical local control is essential. For small benign cystosarcoma phyllodes, a wide local excision can be performed with meticulous, life long, post-operative monitoring. For large tumors or malignant / borderline tumors, a total mastectomy is the procedure of choice. No axillary lymphadenectomy is performed as the rate of axillary metastasis is less than 0.9%. Some authors have proposed a simultaneous sentinel lymphadenectomy; although this approach is reasonable, no guidelines have been set.

• Cystosarcoma Phyllodes with metastasis: Therapeutic guidelines are not available (lack of reported cases and studies).