Phyllodes tumours (PT) are biphasic breast neoplasms composed of both stromal and epithelial elements. They are classified into three groups — benign, borderline, and malignant — with borderline tumours representing roughly 12–26% of all PT. Each subtype has distinct management implications.
This protocol applies to patients with a confirmed diagnosis of borderline phyllodes tumour of the breast. Borderline tumours occupy an intermediate position between benign and malignant PT, and surgical planning must reflect that classification directly.
The primary goal is achieving a clear surgical excision margin. Breast-conserving surgery can be offered where adequate margins are attainable. When broader resection is necessary, specific reconstructive considerations come into play.
The full protocol details the required margin threshold, the decision pathway between breast-conserving surgery and mastectomy, and the criteria governing reconstruction eligibility — none of which are shown here in full.
PT are biphasic with both stromal and epithelial components and are classified into three groups with the following proportions: benign, 50–70%; borderline, 12–26%; and malignant, 20–30%.
For all PT, BCS can be offered if adequate surgical excision margins can be achieved (evidence/grade IV/B).
For borderline PT, aim for a clear surgical excision margin of 5 mm (evidence/grade V/A).
Breast reconstruction should be offered to all patients undergoing mastectomy for PT, but, for patients with malignant PT, careful consideration should be given to the timing of reconstruction including the likelihood of early progression (local and distant), operative recovery time, and potential effects on timing of adjuvant therapy (evidence/grade V/B).
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