During the self-examination, if you feel a lump in the breast, it will always surprise female friends!Generally, what people worry about most is sufferingMalignant breast cancer,orBenign breast fibroadenoma, fibrocyst. Today we are going to talk about a relatively rare type of breast tumor: phylloma.
Symptoms of phylloma
The most obvious symptom of phylloma is a mass. When a patient goes to see a doctor, he may say something like: “I have a self-examination every month and no problem is found, but suddenly this month I found that the bottom of my left breast felt like a lumps near two centimeters.” In other words, this The tumor may grow two or three centimeters in size within a few weeks.
Phylloma is most common in women in their 40s, but phylloid tumors can appear at any age. Younger women are more likely to have benign phyllodes. As they get older, the chance of developing malignant phyllodes will increase.
Characteristics of phyllodes
The reason why phyllodes tumors are called phyllodes tumors is because they appear like phyllodes under the microscope. Phyllomas may be benign or malignant, or even have both benign and malignant characteristics.
Most phyllodes tumors are benign. Not only are the masses very similar to breast fibroadenoma when palpated, butUltrasoundorMammographyIt is also difficult to directly distinguish whether this breast mass is a phylloma or a breast fibroadenoma during imaging examinations. Of course, phyllodes tumors have some characteristics, that is, phyllodes tumors may grow very fast, or grow to a very large size, and you can even see the appearance of lumps even on the skin. But in short, doctors cannot directly determine whether this breast tumor is a phylloma or breast fibroadenoma just from the medical history, palpation, or image. In the end, a biopsy is required to confirm the diagnosis.
Benign phyllodes tumor
When there is a large and fast-growing mass in the breast, it is necessary to remove the tissue from the mass to determine whether there is a possibility of malignant cells inside. Usually, the method of taking out the tumor tissue in the breast can be a thick needle section, or directly removing the entire tumor, and then placing the collected tumor tissue under a microscope to distinguish and determine the characteristics of the tumor tissue.
If a benign phylloid tumor is to be diagnosed under a microscope, it is necessary that these tumors are well differentiated and have intact edges. Some experts and scholars believe that if clinicians suspect that a patient’s breast tumor is a phyllodes tumor, they should try to remove the entire tumor instead of using thick needle sections. After all, the amount of tissue that can be obtained by thick needle slices is much less, which may not allow pathologists to make correct judgments.
If the diagnosis is a benign phyllodes tumor, then this result does not increase the person’s chance of getting breast cancer later. However, it is worth noting that phylloma is a tumor that is more likely to recur, and it may also recur within one or two years after surgery. Therefore, patients must return for regular visits after surgery and follow up with imaging examinations to know whether there is a recurrence. .
Malignant phyllodes tumor
About a quarter of phyllodes tumors are malignant.However, although malignant phyllodes grows on the breast, it is similar to usBreast cancer in generalDifferent. Ordinary people talk about breast cancer, which refers to malignant tumors that grow from the milk ducts or milk lobules, while malignant phyllodes are “malignant sarcomas” that grow from the “connective tissues” next to the milk ducts and milk lobules. The above is not the same.
Therefore, malignant phylloma is different from general breast cancer. Although it grows faster, it is unlikely to metastasize to other organs of the body, and when malignant phylloma expands its sphere of influence, it usually does not go through the lymphatic system, so the condition of the lymph nodes is more Not easily affected. Malignant phylloma also has its own cancer staging method, which is different from the general breast cancer staging.
Since the behavior patterns of malignant phylloma and breast cancer are different, the treatment methods are also different. When it comes to breast cancer treatment, we usually divide the discussion into two aspects: local treatment and systemic treatment.However, due to the low rate of metastasis of malignant phyllodes tumors, most patients only need to receive local treatment.Systemic treatment。
“Surgical resection” is the most important local treatment method. During surgery, in addition to the tumor itself, more normal tissue surrounding the tumor should be used to reduce the chance of recurrence later. If the patient is diagnosed with malignant phyllodes after the entire tumor has been removed, the patient will need another surgery to remove the tissues around the tumor. If the tumor is found to be too large at the beginning of the evaluation, it is necessary to consider direct surgery to remove the unilateral breast.
In general breast cancer surgery, in addition to removing the breast, the lymph nodes are also removed. However, lymph node dissection surgery is rarely required in the treatment of malignant phyllodes. Because even if the malignant phylloid tumor has grown to be quite large, the lymph nodes often remain almost unchanged and do not need to be removed by surgery.
After surgery, patients with malignant phylloma rarely need systemic treatment. Therefore, there is no need for the “hormonal therapy” or “targeted therapy” that is common in the treatment of breast cancer. Local surgery is usually sufficient. Chemotherapy will only be considered for malignant phylloma that has metastasized elsewhere in the body.
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