Phyllodes
Diagnosis Phyllodes
Examination
A phyllodes tumor is often discovered when a woman feels a lump in her breast or something unusual shows up on a mammogram. Following the mammogram, the lump is usually examined using ultrasound. In many cases a biopsy (a piece of tissue) is extracted from the tumor using a hollow needle and examined to see what type of tumor it is.
Problems making the correct diagnosis
It is difficult to make a correct diagnosis from a biopsy for two reasons:
A phyllodes tumor resembles a fibroadenoma.
Phyllodes tumors closely resemble other common but harmless swellings known as ‘fibroadenomas’. A major difference is their growth rates: a fibroadenoma usually grows slowly and does not get much larger than 3 cm in size, whereas a phyllodes tumor grows rapidly and can get much larger. A fibroadenoma can never degenerate into a phyllodes tumor, but the difference is sometimes almost impossible to see under the microscope.
Multiple gradations in the tumor
The gradation (benign, malignant, or borderline) cannot be determined with certainty from the small piece of biopsy tissue. The characteristics that determine the gradation can differ from one place to another within the tumor. Once it has been removed surgically, the entire tumor is therefore examined to make the correct diagnosis.
