Management depends on the age of the patient. In those less than 20 years of age, malignant transformation is rare so that the condition may be regarded as benign. Simple enucleation through a submammary incision is sufficient.
Phyllodes tumours in older patients show a marked tendency to local recurrence. Treatment is by local excision with a good clearance. Mastectomy may be indicated for extensive lesions, older patients, or in patients with small breasts. Local treatment is identical for benign and malignant tumours.
The prognosis for benign phyllodes tumour after surgery is excellent. That for malignant phyllodes tumour depends on the size of the lesion and the histological findings. It is poor for tumours greater than 10 cm diameter and with more than ten mitoses per ten high power fields.
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