Malignant phyllodes tumor of the breast: a systematic review

Pathologica. 2022 Apr;114(2):111-120. doi: 10.32074/1591-951X-754. Epub 2022 Apr 13.


Phyllodes tumors (PT) are fibroepithelial neoplasms of the breast showing a peculiar leaf-like appearance. They account for 0.3 to 1% of all primary breast tumors and 2.5% of all fibroepithelial breast tumors. PT are classified into benign, borderline and malignant based upon their stromal morphology with a distribution of 60%, 20%, and 20%, respectively. Malignant PT of the breast constitute an uncommon challenging group of fibroepithelial neoplasms. They have a relatively high tendency to recur, although distant metastasis is uncommon, and nearly exclusive to malignant PT. Adequate surgical resection remains the standard approach to achieve maximal local control. Giant malignant PT are rare and a pose a diagnostic dilemma for pathologists, especially when comprised of sarcomatous elements. This review highlights the morphological features of PT detected in cytology and histology specimens and discusses diagnostic pitfalls and differential diagnosis.

Keywords: breast disease; breast oncology; fine needle aspiration; malignant phyllodes tumor; pathology; personalized medicine; phyllodes tumor.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Breast / diagnostic imaging
  • Breast / pathology
  • Breast / surgery
  • Breast Neoplasms* / diagnosis
  • Breast Neoplasms* / pathology
  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Neoplasms, Fibroepithelial* / pathology
  • Phyllodes Tumor* / diagnosis
  • Phyllodes Tumor* / pathology
  • Phyllodes Tumor* / surgery