Skip to main content

Phyllodes Tumor of the Breast in Pregnancy and Lactation

  • Chapter
  • First Online:
Diseases of the Breast during Pregnancy and Lactation

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1252))

Abstract

Phyllodes tumor constitutes around 1% of all and 2.5% of fibroepithelial breast lumps. Three types including benign, borderline, and malignant tumors have been described. The benign variant is the most common, is close to fibroadenoma, but is usually larger and recurs more frequently. The rare malignant type is aggressive. Standard treatment consists of lumpectomy with appropriate margins for benign phyllodes tumor, while the borderline and malignant variants must be treated by wide resection or mastectomy. Phyllodes tumor is a rare tumor in pregnancy and lactation, and the effect of gestational alterations in hormone levels on this tumor have not been discussed in the literature, except for several case reports. In summary and alluding to our recent literature review, large size, fast growth, bilaterality, and probably malignancy are more commonly expected in gestational phyllodes tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tan PH, Simpson JF, Tse G, Hanby AM, Lee A (2012). Fibroepithelial tumors. In: WHO classification of tumours of the breast: International Agency for Research on Cancer (IARC), pp 141–148

    Google Scholar 

  2. Brogi E (2015) Fibroepithelial neoplasms. In: Rosen’s breast pathology. Wolters Kluwer, pp 213–170

    Google Scholar 

  3. Chinyama CN (2013). Benign breast diseases: radiology-pathology-risk assessment. Springer Science & Business Media, pp 114–118

    Google Scholar 

  4. Simpson SA, Redstone J, Aziz MS, Bernik SF (2007) Large malignant phyllodes tumor with rapid growth during pregnancy: images of a case. Breast J 13(6):620–621

    PubMed  Google Scholar 

  5. Calhoun KE, Allison KH, Kim JN, Rahbar R, Anderson BO (2014) Phyllodes tumors. In: Diseases of the breast. Wolters Kluwer, pp 826–837

    Google Scholar 

  6. Spitaleri G, Toesca A, Botteri E, Bottiglieri L, Rotmensz N, Boselli S et al (2013) Breast phyllodes tumor: a review of literature and a single center retrospective series analysis. Crit Rev Oncol Hematol 88(2):427–436

    PubMed  Google Scholar 

  7. Lu Y, Chen Y, Zhu L, Cartwright P, Song E, Jacobs L et al (2019) Local recurrence of benign, borderline, and malignant Phyllodes tumors of the breast: a systematic review and meta-analysis. Ann Surg Oncol 26(5):1263–1275

    PubMed  Google Scholar 

  8. Tan BY, Acs G, Apple SK, Badve S, Bleiweiss IJ, Brogi E et al (2016) Phyllodes tumours of the breast: a consensus review. Histopathology 68(1):5–21

    PubMed  PubMed Central  Google Scholar 

  9. Hayati F, Lian HH, Azizan N, Ali AA, Abidin ZAZ, Suhaili MA (2017) Approaches to phyllodes tumour of the breast: a review article. Int Surg J 4(3):841–845

    Google Scholar 

  10. Hamid SA, Rahmat K, Ramli MT, Fadzli F, Jamaris S, See MH et al (2018) Radiopathological characteristics and outcomes of phyllodes tumor of the breast in Malaysian women. Medicine 97(31):e11412

    PubMed  PubMed Central  Google Scholar 

  11. Ruvalcaba-Limón E, Bautista-Piña V, Villegas-Carlos F, Espejo-Fonseca R, Moguel-Molina N, Tenorio-Torres JA et al (2017) Phyllodes tumor of the breast-not all are self-detected. J Xiangya Med 2(6)

    Google Scholar 

  12. Guillot E, Couturaud B, Reyal F, Curnier A, Ravinet J, Laé M et al (2011) Management of phyllodes breast tumors. Breast J 17(2):129–137

    PubMed  Google Scholar 

  13. Yildirim M, Carti EB, Ucar AD, Erkan N, Vardar E, Yakan S et al (2016) Phyllodes tumor of the breast: clinical presentation, management and follow-up. Acta Med Austriaca 32:157

    Google Scholar 

  14. Likhitmaskul T, Asanprakit W, Charoenthammaraksa S, Lohsiriwat V, Supaporn S, Vassanasiri W et al (2015) Giant benign phyllodes tumor with lactating changes in pregnancy: a case report. Gland Surg 4(4):339–343

    PubMed  PubMed Central  Google Scholar 

  15. Andreola J, Damin A, Andreola J, Cruz J, Varella M, Canal L et al (2012) Giant borderline phyllodes breast tumor in pregnancy. J Senolog Int Soc 1(3)

    Google Scholar 

  16. Aranda C, Sotelo M, Torres A, Zárate M (2005) Phyllodes tumor and pregnancy. A report of a case. Ginecol Obstetricia Mex 73(07):387–392

    CAS  Google Scholar 

  17. Ariel L (1961) Skeletal metastases in Cystosarcoma Phylloides: a case report and review. Arch Surg 82(2):275–280

    CAS  PubMed  Google Scholar 

  18. Bal A, Güngör B, Polat AK, Şimşek T (2012) Recurrent phyllodes tumor of the breast with malignant transformation during pregnancy. Eur J Breast Health 8:45–47

    Google Scholar 

  19. Blaker KM, Sahoo S, Schweichler MR, Chagpar AB (2010) Malignant phylloides tumor in pregnancy. Am Surg 76(3):302–305

    PubMed  Google Scholar 

  20. Cha Y, Kim H-W, Kim HS, Won TW (2017) Spontaneous infarction of Phyllodes tumor of the breast in a postpartum woman: a case report. Korean J Radiol 77(5):327–332

    Google Scholar 

  21. Chai SC, Umayaal S, Saad AZM (2015) Successful pregnancy “during” pedicled transverse rectus abdominis musculocutaneous flap for breast reconstruction with normal vaginal delivery. Indian J Plast Surg 48:81

    PubMed  PubMed Central  Google Scholar 

  22. de Carvalho Jr AW, da Silva SMM, Almeida PBL, da Silva OQ, Schumaltz LEP, de Sousa JA et al (1999) Gravidez e tumor filodes bilateral: Uma Associação Rara. RBGO 21(2):109

    Google Scholar 

  23. Furuya S, Miura K, Aikawa T, Nakagomi H, Mri M, Oyama T et al (2012) A case of phyllodes tumor of the breast grown rapidly during the last period of pregnancy. J Jpn Soc Clin Surg 73(4):780–785

    Google Scholar 

  24. Gentile LF, Gaillard WF, Wallace JA, Spiguel LR, Alizadeh L, Lentz A et al (2016) A case of a giant borderline phyllodes tumor early in pregnancy treated with mastectomy and immediate breast reconstruction. Breast J 22(6):683–687

    PubMed  Google Scholar 

  25. Hernanz F, González-Noriega M, Arozamena B, Solano J, García J (2018) Bilateral synchronous breast malignant phyllodes in a pregnant woman. Breast J 24(3):412–413

    PubMed  Google Scholar 

  26. Kallam AR, Kanumury V, Korumilli RM, Gudeli V, Polavarapu H (2017) Massive benign phyllodes tumour of breast complicating pregnancy. J Clin Diagn Res 11(5):PD08–PD09

    PubMed  PubMed Central  Google Scholar 

  27. Kelten C, Boyaci C, Leblebici C, Behzatoglu K, Trabulus DC, Sari S et al (2016) Malignant phyllodes tumor including aneurysmal bone cyst-like areas in pregnancy-a case report and review of the literature. Breast Care 11(4):291–294

    PubMed  PubMed Central  Google Scholar 

  28. Lee MV, Shaw HL, Chi T, Brazeal HA, Holley SO, Appleton CM (2018) Palpable breast abnormalities in women under age 40. Breast J 24(5):798–805

    PubMed  Google Scholar 

  29. Lester J, Stout AP (1954) Cystosarcoma phyllodes. Cancer 7(2):335–353

    CAS  PubMed  Google Scholar 

  30. Li X, Yang Y, Wang J, Ma B, Jin Y, Li R (2008) Surgical treatment of giant recurrent breast phyllodes tumor. J Huazhong Univ Sci Technolog Med Sci 28(6):688–692

    PubMed  Google Scholar 

  31. Mrad K, Driss M, Maalej M, Romdhane KB (2000) Bilateral cystosarcoma phyllodes of the breast: a case report of malignant form with contralateral benign form. Ann Diagn Pathol 4(6):370–372

    CAS  PubMed  Google Scholar 

  32. Murthy SS, Raju K, Nair HG (2016) Phyllodes tumor in a lactating breast. Clin Med Insights Pathol 9:13–17

    PubMed  PubMed Central  Google Scholar 

  33. Narla SL, Stephen P, Kurian A, Annapurneswari S (2018) Well-differentiated liposarcoma of the breast arising in a background of malignant phyllodes tumor in a pregnant woman: a rare case report and review of literature. Indian J Pathol Microbiol 61(4):577–579

    PubMed  Google Scholar 

  34. Nejc D, Pasz-Walczak G, Piekarski J, Pluta P, Bilski A, Sek P et al (2008) Astonishingly rapid growth of malignant cystosarcoma phyllodes tumor in a pregnant woman—a case report. Int J Gynecol Cancer 18(4):856–859

    CAS  PubMed  Google Scholar 

  35. Pacchiarotti A, Frati P, Caserta D, Pacchiarotti A, Frega A, Moscarini M (2011) First case of transformation for breast fibroadenoma to high-grade malignant cystosarcoma in an in vitro fertilization patient. Fertil Steril 96(5):1126–1127

    PubMed  Google Scholar 

  36. Pandit A, Vora I, Shenoy S, Gurjar A (1985) Bilateral cystosarcoma phylloides with osteogenic sarcomatous stroma (a case report with review of literature). J Postgrad Med 31(4):215–216

    CAS  PubMed  Google Scholar 

  37. Pasta V, Amabile MI, Bizzarri M, Monti M (2012) Breast sarcoma in a pregnant patient. Ann Ital Chir 28:2012

    Google Scholar 

  38. Pytel J, Dedecjus M, Naze M, Strózyk G, Brzezinski J (2009) Malignant breast phyllodes tumor in pregnancy – a case report. Prz Menopauzalny 13(6):331

    Google Scholar 

  39. Ray S, Basak S, Das S, Pal M, Konar H (2011) Malignant phylloides tumor of breast in a pregnant woman with coincidental nulliparous vaginal prolapse. Iran J Med Sci 36(4):315–317

    PubMed  PubMed Central  Google Scholar 

  40. Reich T, Solomon C (1958) Bilateral cystosarcoma phyllodes, malignant variant, with a 14-year follow up: a case report. Ann Surg 147(1):39–43

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Sharma JB, Wadhwa L, Malhotra M, Arora R, Singh S (2004) A case of huge enlargement of cystosarcoma phylloides of breast in pregnancy. Eur J Obstet Gynecol Reprod Biol 115(2):237–239

    CAS  PubMed  Google Scholar 

  42. Testori A, Meroni S, Errico V, Travaglini R, Voulaz E, Alloisio M (2015) Huge malignant phyllodes breast tumor: a real entity in a new era of early breast cancer. World J Surgical Oncol 13(1):81

    Google Scholar 

  43. Tortoriello MG, Cerra R, Di Bonito M, Botti G, Cordaro FG, Caputo E et al (2017) A giant phyllodes tumor of the breast: a case report in pregnancy. Ann Clin Case Rep 2:1311

    Google Scholar 

  44. Vergine M, Pasta V, Redler A, Santucci E, Vasselli I, Ballesio L et al (2012) Cystosarcoma phylloides of the breast: a rare diagnosis. Ann Ital Chir 83(6):547–549

    PubMed  Google Scholar 

  45. Vintea A, Sima R, Burcoș T, Bănceanu G, Toader O (2016) The management of a rare breast tumor in pregnancy. J Surg Sci 3(4):187–191

    Google Scholar 

  46. Ward RM, Evans HL (1986) Cystosarcoma phyllodes. A clinicopathologic study of 26 cases. Cancer 58(10):2282–2289

    CAS  PubMed  Google Scholar 

  47. Way JC, Culham BA (1998) Phyllodes tumour in pregnancy: a case report. Can J Surg 41(5):407

    CAS  PubMed  PubMed Central  Google Scholar 

  48. Weledji EP, Enow-Orock G, Ngowe MN, Aminde L (2014) Breast-conserving surgery is contraindicated for recurrent giant multifocal phyllodes tumours of breast. World J Surg Oncol 12(1):213

    PubMed  PubMed Central  Google Scholar 

  49. White TT (1954) Carcinoma of the breast and pregnancy: analysis of 920 cases collected from the literature and 22 new cases. Ann Surg 139(1):9–18

    CAS  PubMed  PubMed Central  Google Scholar 

  50. Hill RP, Stout AP (1942) Sarcoma of the breast. Arch Surg 44(4):723–759

    Google Scholar 

  51. Alipour S, Eskandari A, Johar FM, Furuya SH (2020) Phyllodes tumor of the breast during pregnancy and lactation: a systematic review. Arch Iran Med Ahead of Printing

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sadaf Alipour .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Alipour, S., Eskandari, A. (2020). Phyllodes Tumor of the Breast in Pregnancy and Lactation. In: Alipour, S., Omranipour, R. (eds) Diseases of the Breast during Pregnancy and Lactation. Advances in Experimental Medicine and Biology, vol 1252. Springer, Cham. https://doi.org/10.1007/978-3-030-41596-9_19

Download citation

Publish with us

Policies and ethics