Overview
Phyllodes tumours are rare breast tumours. They originate in the connective tissue of the breast. Phyllodes mean "leaflike." It is said so because as the tumours grow, they appear to have the shape of a leaf under the microscope. Therefore, it is termed phyllode tumour. The possibility for phyllodes tumours is less than 1 per cent.
Most phyllode tumours are benign, which means non-cancerous. They rarely spread to other parts of your body. However, it may be cancerous or show malignancy in a few cases.
Types of Phyllodes Tumour
Phyllodes tumours are classified into three groups based on their appearance under a microscope. They are:
Benign
This indicates that they are non-cancerous. They are less likely to spread. The majority of the phyllode tumours are Benign tumours.
Borderline
Tumours may have both non-cancerous or benign and cancerous features.
Malignant
Tumours are those that have cancerous features. They are likely to multiply and spread to other adjacent organs of your body. They may relapse after treatment.
Phyllodes Tumour Causes
The exact cause of phyllodes tumours is not clear. However, it occurs in women of any age. Though it may be expected after the forties. Even males with a history of gynecomastia may also develop phyllodes tumours. Gynecomastia is the abnormal development of breasts in males. Nonetheless, phyllodes in males are very rare.
Phyllodes Tumour Symptoms
It is usually without any symptoms when it is slowly growing or small in size. A phyllodes tumour may grow rapidly and show symptoms irrespective of its type. It includes:
- The tumour appears as a smooth lump under the breast
- The skin overlying the lump shows reddish discolouration
- The tumour growth may be rapid that it is visible under the skin
- Painful lump (Some time)
- Pain may radiate to the entire breast
- Swelling in a particular area or the entire breast
- Tumour ruptures out of the skin and forms an open sore
- Nipple gets inward
- Thickening of nipple or skin overlying your breast
- Dimpling of skin around the lump
Phyllodes Tumor Diagnosis
The diagnosis is based on the signs, symptoms, and investigations. The investigations include physical examination, investigation routine blood investigations and confirmatory tests. You may have to undergo one or more of these tests. These confirmatory tests help to diagnose and rule out the phyllodes tumour. They include:
- A mammogram gives a detailed picture of the lump. The result shows a well-defined round or oval-shaped tumour. Calcium deposits may be observed in it.
- Fine Needle Aspiration Biopsy (FNAC) uses a needle to aspirate or pull out a small tissue from the growth or lump. It is examined under the microscope to check for cancer cells or features.
- Ultrasound uses sound waves to capture pictures of the tumour. It helps your doctor to evaluate the size and structure of the lump.
- Magnetic Resonance Imaging (MRI scan) is used to create a three dimensional and cross-sectional image of your breasts. You get well-refined images using MRI.
- Tru Cut / core needle biopsy a small piece of tumour is taken out using a thick needle to look into microscopy for assessing type of tumour.
Phyllodes Tumour Treatment
The treatment is decided based on the investigations, nature of the tumour, and your medical history. Surgical removal of the tumour is the treatment of choice for Phyllodes tumour. However, various types of surgery are performed to treat phyllodes tumours. The choice of surgery depends on the nature and size of the tumour. The type of surgery includes:
Lumpectomy
It is the surgical removal of the tumour. It also removes a certain amount of tissue surrounding the tumour. Removing this excess tissue may prevent the relapse of the tumour from coming back.
Total mastectomy
It is the complete removal of the breast. It helps to cure breast cancer if diagnosed in the initial stages. After the surgery, you can undergo breast reconstruction surgery.
Radiotherapy
It uses high-intensity waves to suppress cancer cells. It is usually done after surgery for the malignant phyllodes tumour. It is also noted that radiotherapy is done when cancer has not involved the adjacent or nearby organs.
Chemotherapy
It uses medicines or drugs to kill cancer cells across your body. It is optional if cancer has spread to other organs. Radiotherapy and Chemotherapy are usually not required. It is sometimes Radiotherapy and Chemotherapy given in recurrent case or malignant phyllodes / metastatic phyllodes.
Outlook
Phyllodes tumour is a rare breast tumour. It is mostly benign. The prognosis of the success rate in cancer treatment is excellent. Surgery is the treatment of choice. Treatment is effective in malignant phyllodes tumours with early diagnosis. Benign tumours are less likely to relapse or regrow. Nonetheless, you may be monitored for a year or two after the treatment. After surgery, during a self-examination, if you notice any breast changes, your doctor may inform you.
If untreated or ignored, even a benign phyllodes tumour may cause complications. Therefore, it is advised to seek medical attention if you notice any abnormality in your breast.