Malignant Phyllodes in Lymph Nodes

[CPT]

Well here I am almost three years post high grade malignant phyllodes of the breast and it got me again.  Only thing is it hasn't returned locally.  It turns out that it has grown in my lymph nodes.  I thought that wasn't possible and that lymph nodes are not involved with this type of tumor.  Now I am concerned because I am wondering if there will be recommendations for alternate treatment other than just surgery.  What can you share, if anything on such a situation?  I am meeting a soft tissue sarcoma specialist today.

[Cleveland Clinic]

Dear CPT:  About 90% of phyllodes tumors are benign. These are treated with wide excision and may recur locally but are unlikely to metastasize or spread.  Malignant phyllodes tumors comprise about 10% of phyllodes tumors.  These are also treated with wide excision and/or mastectomy. Lymph node dissection is usually not performed because of the low risk for lymph node involvement at the time of evaluation.  Radiation is considered when margins are close.  The primary difference between benign phyllodes tumors and malignant phyllodes tumors is the ability or malignant phyllodes tumors to metastasize (spread).  Recurrence in the lymph nodes or lungs are among the most common sites of recurrence.  If this occurs, it is treated as a sarcoma would be treated.  You are on the right tract seeing a sarcoma specialist.