Follow up phyllode tumor (malignant)

[woogy]

I have had recent surgery to remove a malignant phyllode tumor and again to acheive clear margins. With clear margins now my recommended follow up is to have yearly mammograms. In 2001 I had a biopsy for a fibroadenema that showed it was benign, follow up was yearly mammo. The most recent report is that this malignant phyllode is the same small fibroadenema they have seen for 7 years now large and malignant. The path. report states malignant phyllode tumor w/marked sarcomatous overgrowth. Sarcomatous (stromal) component demonstrates increased mitotic activity >20mitosis/10HPF, nuclear atypia. Ductal componant has prominant intracanicular pattern and forms "leaflike" patterns. Do you agree with this follow up plan? I have never received any scans to check for matastisis. Also how would this tumor be graded? I was told 1) they are not graded 2) this is lowgrade 3) high mitosis and stromal overgrowth indicates high grade. Now I don't know what grade it is (no note on path. report) Thanks

[Dennis MD]

Hi.
Phylloides tumor is an uncommon type of breast neoplasm.  It is similar to fibroadenoma both in clinical presentation and histologically (microscopic appearance).  The more benign-appearing tumor is called phylloides tumor, while the malignant-appearing is called phylloides sarcoma.
Phylloides tumors are treated with surgical excision.  Good surgical margin should be achieved since this can recur locally.  Phylloides sarcomas are treated with mastectomy or surgical excision plus radiotherapy.  
I suggest close follow-up with your oncologist.  
Take care.      

[healingwell62]

Wow, you've said a mouthful!  Hi Woogy, I'm Chris the Community Leader for the breast cancer community.  I have no expertise to try to answer your question.  You might try posting this question on the ask an expert forum, but hopefully one of our physicians is keeping an eye out and will respond to your question.  If I can be of any help via the breast cancer forum, please don't hesitate to contact me!

Warmly,

Chris