Contemporary Management of Phyllodes Tumors

Phyllodes tumors (PT) are rare fibroepithelial lesions of the breast. It is critical to understand the behavior of benign, borderline, and malignant PT so as to recommend appropriate treatment. This review describes findings on diagnostic testing and pathology that differentiate these tumors, as well as recommended management.

Better understanding of outcomes following PT resection has led to changes in local therapy recommendations, with wide margins (> 1 cm) strongly recommended for malignant PT only. Other PT may be resected with smaller (or no) margin without impact on local recurrence risk. Adjuvant radiation should be considered in malignant PT or when local recurrence would lead to significant morbidity.

Benign and borderline PT may not require wide margins at excision for optimal local control. Malignant PT should be resected with wide margins and consideration given to adjuvant radiation therapy.