Category Archives: Cystosarcoma phyllodes

Giant fibroadenoma of the Breast

Breast Cancer, Breast Disease, Cystosarcoma phyllodes, Giant Fibroadenoma

Giant Fibroadenoma of the Breast

  • Rare and generally occur in women age 15-20 years old.
  • Rapid growth
  • Can exceed 5 cm
  • Observation is not recommended for some patients because the rapid growth can lead to further problems (infarction, deformities)
  • Giant Fibroadenoma should be excised also to exclude a phyllodes tumor in addition to preventing futher problems of infarction and deformities.

Facts about Phyllodes tumors

Breast Cancer, Breast Disease, Cystosarcoma phyllodes, Nipple Discharge

Phyllodes tumors of the breast:

  • Not easily distinguished from fibroadenomas on physical exam and even challenging on radiological studies
  • Rarely involve the nipple-areolar complex
  • Most are in the upper outer quadrant
  • Central phyllodes tumors may present with bloody nipple discharge or nipple retraction
  • Few have been reported in men
  • Primary goal for treatment of phyllodes tumor is to achieve a wide negative margin with a rim of at least 1 cm of uninvolved tissue.
  • Total mastectomy may be required for lesions too big to achieve a 1 cm margin without markedly deforming the breast or for repeated local recurrences

 

Breast Masses in Children

Benign Breast Disease, Breast Disease, Cystosarcoma phyllodes, Pediatric Breast, Pediatric Breast Mass, , , ,

Breast Masses in Children and Adolescence

Classification of the breast masses in children/adolescence

The process in parethesis below represents an example.

  • Physiological (Gynecomastia)
  • Inflammatory (Abscess)
  • Benign neoplastic (Fibroadenoma, Cystosarcoma phyllodes)
  • Primary malignant (Cystosarcoma phyllodes)
  • Secondary malignant (Lymphoma)

Neonatal breast nodules

Usually due to stimulation by maternal hormones

Cystosarcoma Phyllodes

  • Fibroadenomas and cystosarcoma phyllodes are the most common lesions of the breast in childhood.
  • Cystosarcoma phyllodes present as either benign or malignant but 95% in children are benign.

Best test for initial assessment in pediatric patients with breast mass?

Ultrasound

Then what modality for diagnosis of the breast mass?

Fine needle aspiration.  FNA is preferred over core needle biopsy because of the possibility of deformity of the breast in the future with core needle biopsy.

What about excision biopsy in the pediatric breast?

Excisional biopsy should be avoided as an initial diagnostic procedure because the developing breast bud can be mistakenly removed, leading to deformity.