Recurrent borderline phyllodes tumor of the breast submitted to mastectomy and immediate reconstruction: Case report

Skin reducing nipple sparing mastectomy with immediate breast reconstruction for huge borderline phyllodes tumor of the breast: Case report

INTRODUCTION

Borderline phyllodes tumors are very infrequent breast tumors encountered by surgeons.

CASE PRESENTATION

We present a case of a young woman with a very large borderline phyllodes tumor measuring 20 cm × 20 cm, involving almost all of the breast, causing gross asymmetry of the breasts.

DISCUSSION

The patient wished to maintain symmetry following the surgery as a result of which a simple mastectomy followed by implant based Immediate breast reconstruction was planned. The patient had an uneventful recovery postoperatively with equal breast size bilaterally.

CONCLUSION

Implant based immediate breast reconstruction thus provides a comprehensive solution and excellent cosmesis for women with very large borderline phyllodes requiring mastectomy.

Large borderline phyllodes breast tumor related to histopathology, diagnosis, and treatment management - case report

Breast phyllodes tumors (PTs) are uncommon tumors with a biphasic fibroepithelial component, characterized by rapid development in middle-aged women. A correct preoperative diagnosis after Tru-Cut biopsy allows for proper surgical planning. The treatment of choice remains surgery (wide local excision or mastectomy) with or without breast reconstruction, depending on the size and histopathological (HP) nature of the tumor. We reported a case of a 50-year-old woman with a large PT in her left breast, measuring 11/10 cm. Preoperative HP examination revealed biphasic proliferation, with the appearance of benign PT. The patient underwent a left mastectomy, with a favorable postoperative evolution. The final HP diagnosis was borderline PT, with areas of lipomatous metaplasia. After three months, breast reconstruction was performed. The therapeutic management of large PTs continues to be a challenge for pathologists and surgeons. Due to the increased frequency of local recurrence and HP progression to malignancies, the treatment of choice for these patients is mastectomy, without lymphadenectomy.