Treatment of Malignant Phyllodes Tumour of Breast with Distant Metastasis
Clinical Scenario
Malignant phyllodes tumour of the breast carries an approximate 20% risk of distant metastasis — most commonly to the lungs — typically occurring within 2 years of primary treatment. This page addresses the management approach once distant spread has been confirmed.
Disease Context
Metastatic malignant phyllodes tumour should be managed in accordance with local guidelines for soft tissue sarcoma (STS). The extent and distribution of metastatic disease — in particular whether it is limited (oligometastatic) — directly shapes the treatment strategy.
Approach (Overview Only)
For carefully selected patients with limited metastatic burden, surgical intervention at metastatic sites may be considered following multidisciplinary team discussion. Where surgery is not suitable, a non-surgical local treatment option may be an alternative — access the full protocol for the complete decision pathway.
References
DOI: 10.1093/bjs/znaf152
Malignant PT also carry a risk of distant metastasis of approximately 20%, mostly to the lungs, which tends to occur within 2 years of primary treatment.
Metastatic malignant PT should be managed as per local guidelines for STS (evidence/grade V/A).
In small-volume oligometastatic disease, metastasectomy should be considered if appropriate, after sarcoma MDT discussion (evidence/grade V/A).
In small-volume oligometastatic disease where metastasectomy is not feasible/acceptable, SBRT could be considered (evidence/grade V/A).
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