Chapter 55: Breast- Cystosarcoma Phyllodes

Question 1

What is it?

Answer 1

Mesenchymal tumor arising from breast lobular tissue; most are benign

(Note:“Sarcoma” is a misnomer, as the vast majority are benign; 1% of breast cancers)

Question 2

What is the usual age of the patient with this tumor?

Answer 2

35 to 55 years (usually older than the patient with fibroadenoma)

Question 3

What are the signs/symptoms?

Answer 3

Mobile, smooth breast mass that resembles a fibroadenoma on exam,mammogram/ultrasound findings

Question 4

How is it diagnosed?

Answer 4

Through core biopsy or excision

Question 5

What is the treatment?

Answer 5

If benign, wide local excision

if malignant, simple total mastectomy

Question 6

What is the role of axillary dissection with cystosarcoma phyllodes tumor?

Answer 6

Only if clinically palpable axillary nodes, as the malignant form rarely spreads to nodes (most common site of metastasis is the lung)

Question 7

Is there a role for chemotherapy with cystosarcoma phyllodes?

Answer 7

Consider chemotherapy if large tumor >5 cm and “stromal overgrowth”