Phyllodes tumours: How are these rare breast neoplasms best managed? This review addresses the diagnosis and management of phyllodes tumours, rare fibroepithelial lesions accounting for less than 1% of all breast neoplasms. Given the non-operative management of fibroadenomas, distinguishing phyllodes tumours from other benign breast lesions is vital. Triple assessment is recommended for all breast lumps, especially in women over 35 presenting with a rapidly growing “benign” lump. Treatment involves wide excision or mastectomy with clear margins. Axillary dissection is not routinely recommended due to rare nodal metastases. Clinical and histological prognostic factors are unreliable, and local recurrence occurs in approximately 15% of patients. Malignant phyllodes tumours develop distant metastases in about 20% of patients, with rare long-term survival. The roles of chemotherapy, radiotherapy, and hormonal manipulation remain to be defined. This review provides guidance for the effective diagnosis and management of phyllodes tumours, emphasizing the need for clear specimen margins and individualized treatment strategies.
Published in the Postgraduate Medical Journal, this review aligns with the journal's focus on providing practical guidance for medical professionals. By offering a comprehensive overview of phyllodes tumors and their management, it directly addresses the needs of postgraduate medical practitioners seeking up-to-date information on this rare condition.