Malignant Phyllodes Tumor Of Breast Research Articles

NKILA is a novel suppressor of local recurrence in women breast malignant phyllodes tumor patients via inhibition of the NF-κB pathway

The aim of the present study was to explore the functional mechanism of NF-Kappa B-interacting Long non-protein coding RNA (NKILA) in breast malignant phyllodes tumors (BMPTs). The expression and functional role of NKILA were investigated by performing qRT‒PCR, Transwell assays, and CCK‒8 assays in primary BMPT cells. A Kaplan‒Meier curve was used to assess overall survival (OS) and local recurrence-free survival (LRFS). The location and expression levels of NKILA and P65 were determined by fluorescence in situ hybridization (FISH) and immunofluorescence (IF), respectively. NKILA was downregulated in patients with BMPT, especially in patients with local recurrence. NKILA had an antitumor effect and promoted the chemosensitivity of cells to cisplatin by blocking P65 phosphorylation and nuclear translocation. In conclusion, NKILA may be a potential therapeutic target for BMPT, especially for BMPT patients with local recurrence.

Abstract PO1-17-01: Surgical Margins and prognosis of borderline and malignant phyllodes tumors of breast

Abstract Background. To determine the appropriate surgical margin and identify predictive factors for recurrence and prognosis of borderline and malignant phyllodes tumor (PT) of the breast. Methods. A retrospective review of patients with borderline and malignant PT treated from March 2011 to December 2022 at the First Affiliated Hospital of Chongqing Medical University were conducted. The main endpoints of this research were local recurrence-free survival (LRFS) and disease-free survival (DFS). Univariate and multivariate Cox proportional hazard models were used to examine the impacts of different variables on LRFS and DFS, and to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results. Of 155 patients with phyllodes tumors, 87 (56.1%) were classified as borderline while 68 (43.9%) were malignant. All patients included underwent operation, with a median age of 47 years (range,12-66 years) and a median tumor size of 60 mm (range,15-300 mm). Initial surgical margins < 1cm in 72 (46.5%) patients, of which 28 (38.9%) underwent reoperation, resulting in 45 (28.4%) patients with a margin < 1cm and 111 (71.6%) patients with a margin ≥1cm. At a median follow-up period of 66 months (range 3-146 months), local recurrence was observed in 36 patients (23.2%), and distant metastasis occurred in 10 patients (6.5%). In this cohort, the rates of 5-year LRFS was significantly higher in the surgical margin ≥1 cm group than in the surgical margin < 1 cm group (83.8% vs 50.4%, log-rank P< 0.001), both for the borderline (log-rank P=0.010) and the malignant PT (log-rank P< 0.001).Similarly, for both borderline (log-rank P=0.019) and malignant PT (log-rank P< 0.001), the rates of 5-year DFS was significantly higher in the surgical margin ≥1 cm group than in the surgical margin < 1 cm group (80.3% vs 47.5%, log-rank P=0.002). For 72 patients with the initial margin < 1 cm, 5-year DFS for undergoing reoperation to achieve a margin ≥1 cm and remaining with a margin < 1 cm were84.1% and 47.5%, respectively (P=0.008). In univariate analysis of the entire cohort, age, fibroadenoma surgery history, surgical methods, and surgical margins emerged as predictive factors for LRFS (P=0,003, 0.019, 0.026, and0.001, respectively), whereas age, reproductive history, fibroadenoma surgery history, tumor size and surgical margins were predictors of DFS (P= 0,011, 0.025, 0.039, 0.022, and0.002, respectively).In multivariate analysis, age< 45 years (HR=2.186, 95%CI:1.105-4.328, P=0.025)and surgical margins< 1cm (HR=2.181, 95%CI:1.021-4.659, P=0.044) were independent risk factors of LRFS. Independent risk factors for DFS included tumor size>5cm (HR=2.265, 95%CI:1.113-4.606, P=0.024) and surgical margins < 1cm (HR=2.689, 95%CI:1.438-5.027, P=0.002). Conclusion. For borderline and malignant PT, surgical margins of at least 1 cm should be achieved for a better prognosis. Patients aged < 45 years with a high risk of local recurrence and larger tumor patients with poor prognosis, multiple therapy modalities may be required for these high-risk patients. Survival curves for impact of variables on LRFS and DFS Table 1 Univariate and multivariate analysis of LRFS of PTs of the breast (n=155) Table 2 Univariate and multivariate analysis of DFS of PTs of the breast (n=155) Citation Format: lu Gan, Jialin Su. Surgical Margins and prognosis of borderline and malignant phyllodes tumors of breast [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-17-01.

Surgical Bedside Electrochemotherapy for Local Control of a Recurrent Phylloid Malignant Breast Tumor: A Case Report.

We present the case of a recurrent malignant phyllodes tumor of the breast, after mastectomy and radiotherapy, in which electrochemotherapy (ECT) was applied to the tumor bed, to achieve better local control. A 66-year-old woman with a large malignant phyllodes tumor of the right breast with a size of 40 cm underwent right radical mastectomy and right axillary lymph node sampling. One month after surgery, with histologically clear margins, the woman presented with multiple small oval masses in the upper portion of the chest wall, indicating rapid disease progression. A second radical excision with clear margins was performed, followed by adjuvant radiotherapy. Two months after the end of treatment, a new 3-cm mass was present in the right axillary extension. The patient underwent a third extensive debulking surgery. At the end of the resection, ECT was applied on the tumor bed along the extensive skin flaps and resection margins. After eight months of follow-up, breast magnetic resonance imaging and total body computed tomography showed disease recurrence in the anterior portion of the right serratus muscle and in the lungs bilaterally. The area undergoing previous ECT showed no disease recurrence. The patient received two lines of palliative chemotherapy. She died 28 months after diagnosis. At the time of death, the large area treated with ECT was geometrically spared from local disease progression. This case report suggests the potential efficacy of ECT at the operating bedside to increase local control in aggressive malignancies.

Clinical perspectives and outcomes of the giant breast phyllodes tumor and sarcoma: a real-world retrospective study

BackgroundGiant breast malignant phyllodes tumor or sarcoma (GBPS) are rare entities with diameter larger than 10 cm and variously histological pleomorphisms. This disease poses a significant threat to the quality of life of individuals, and its prognosis remains unclear. This study aimed to explore the differential diagnosis, treatment, and prognosis of GBPS in a real-world retrospective cohort.MethodsWe collected GBPS (diameter > 10 cm, n = 10) and BPS (diameter ≤ 10 cm, n = 126) from patients diagnosed with sarcoma or malignant phyllodes tumor between 2008 and 2022. We analyzed clinical characteristics, histological status, treatment, and local recurrence using the Fisher’s exact test between GBPS (diameter > 10 cm) and BPS (diameter ≤ 10 cm) cohort. We described overall survival (OS) and disease-free survival (DFS) using Kaplan–Meier curves and identified risk factors for local recurrence using logistic regression. The tumor size, age at diagnosis, and differential immunohistochemistry markers of breast sarcoma or phyllodes tumor to determine the prognosis of GBPS.ResultsIn our retrospective analysis of breast malignancies, we identified 10 cases of GBPS and 126 cases of BPS, corresponding to a GBPS prevalence of 0.17% (10/6000). The median age was 38.5 years (inter-quartile range, IQR: 28.25–48.5 years). During the follow-up of period (median: 80.5 months, IQR: 36.75–122 months), the local recurrence (LR) rate was 40% and 20.6%, respectively. Clinical characteristics of young age (HR:2.799, 95%CI -00.09276—0.017, p < 0.05) and cytological characteristics of marked stromal atypia (HR:0.88, 95% CI 0.39–1.40, p < 0.05) were risk factors for the poor prognosis of GBPS by COX regression model analysis. The Kaplan–Meier curves of GBPS 5-year disease-free survival (DFS) and overall survival (OS) were 31.5 months and 40 months, respectively, and were not associated with adjuvant radiation or chemotherapy.ConclusionWe recommend mastectomy with a clear surgical margin as the preferred treatment for GBPS. Age and stromal atypia are significantly associated with recurrence. Adjuvant radiation therapy is advised; however, there was no improvement in overall survival. There is no consensus on the effectiveness of adjuvant chemotherapy and genetic methods, highlighting the need for further research into this aggressive tumor. We recommend a multidisciplinary approach involving a dedicated team for the management of GBPS.

DIAGNOSTIC PERPLEXITY: METAPLASTIC CARCINOMA OF BREAST VERSUS MALIGNANT PHYLLODES TUMOR OF BREAST

Metaplastic breast carcinoma is an uncommon breast neoplasm constituting less than 1% of all breast cancers. It is more aggressive and has poorer prognosis than other breast carcinomas. It has variable and similar presentation to others. With this case report of a 76-year-old female who presented with a large tender rapidly progressive erythematous lump, we aim to reveal the rarity in pathologic and clinical features of the metaplastic breast carcinoma and its similarities to malignant phyllodes tumor of breast. It has been later diagnosed post operatively as Metaplastic carcinoma of breast. Immunohistochemistry plays an important role in its diagnosis.

Unusual and Isolated Pulmonary Metastasis of Malignant Phyllodes Tumour of Breast

Unusual and Isolated Pulmonary Metastasis of Malignant Phyllodes Tumour of Breast

Study of CD117 Expression on Phyllodes Tumor of Breast and Its Correlation with Histopathological Grade

Background: Accurately predicting the nature and differentiating of various grades of Phyllodes tumor, the diagnosis may vary by different pathologists1, as there is no standard interpretation of the histologic cut-point criteria and therefore. In this study, we evaluated the impact of CD117 expression on Phyllodes tumor of breast and usefulness of this marker to differentiating benign from malignant phyllodes tumors. Methods: This cross-sectional observational study was conducted in the Department of Pathology, Dhaka Medical College. The study includes mastectomy/lumpectomy specimens received from surgery and surgical oncology departments and diagnosed as phyllodes tumor histopathological. Tissue processing and staining were performed using standard protocol. Histopathological typing and grading were done according to WHO recommended criteria 2012. Immunostaining for CD117 done on all 50 cases. Toluidine blue staining was performed on CD117 immunostaining positive cases, to see presence of mast cells. Result: This study consists of 50 cases of phyllodes tumor of breast. In all the cases immunohistochemistry was done with markers CD117. Histological Grading of phyllodes tumor was done using stromal cellularity, nuclear pleomorphic, stromal overgrowth, mitotic rate, margin of tumor. Statistical analysis was done and results were compared with various available previous studies. This study showed that most of benign/low grade phyllodes tumors belonged to the age group of 35-46 years and most of malignant phyllodes tumors belonged to the age group of 30.50-47.50 malignant phyllodes tumor in this study was 40 years. Overall 44% (22 out of 50) of the cases showed positivity for CD117 in the stroma. Among them 85% cases of malignant Phyllodes tumors of breast shows stromal expression of CD117. This study shows association of CD117 expression with malignant phyllodes tumor. Epithelial CD117 positivity was found in 69.5% cases of benign/low grade Phyllodes tumors of breast. Current study also shows association of CD117 epithelial expression with benign phyllodes tumor the result of our study show strong correlation between CD117 expression and histopathological grade. Conclusion: In conclusion, we can report an association of CD117 protein expression in borderline/malignant tumors and which may be associated with worse prognosis. So we can suggest for targeted therapy for these patient group having Phyllodes Tumor with positive CD117 expression.

SURGICAL MANAGEMENT OF PATIENTS DIAGNOSED WITH MALIGNANT PHYLLODES TUMOR OF THE BREAST IN THE NATIONAL ONCOLOGY INSTITUTE “DR. JUAN TANCA MARENGO” SOLCA – GUAYAQUIL

The aim is to establish the real relationship of incidence of the Malignant phyllodes Tumor of Breast and its effective surgical approach in patients treated at the Oncological Institute of Guayaquil, the reference center of Ecuador.&#x0D; Objective: To establish the surgical management of Malignant phyllodes Tumors of Breast in the Oncological Institute of Ecuador SOLCA.&#x0D; Method: An analysis of the cases diagnosed and operated in the Oncological Institute of Guayaquil SOLCA in the period September 2009 to September 2019, based on a retrospective descriptive study to determine the surgical management of phyllodes tumors is performed.&#x0D; Results: Within the study period (9 years), 24 patients with Malignant phyllodes Tumor of Breast who met the admission criteria were analyzed. Two groups were established: 75% (n = 18) who left “alive” from the hospital and 25% “deceased” (n = 6). An analysis of the mortality adjusted to the surgical procedure was performed, where it can be observed that the radical mastectomy showed a survival of 82%, while the simple mastectomy and the lumpectomy, procedures chosen as the first option for the treatment of the malignant phyllodes tumor, presented a Survival less than 40%.&#x0D; Conclusions: The phyllodes malignant breast tumor has a low incidence among malignant breast tumors. It seems that radical mastectomy of the breast is the best option for patients with this type of cancer, and adjuvance does not improve patient survival.

Impact of RASSF1A gene methylation on clinico-pathological features of tumor and non-tumor tissue of breast cancer

BackgroundBreast cancer is the most common malignancy in women caused by genetic and epigenetic changes. Promoter DNA methylation in tumor suppressor gene plays a major role in breast cancer. The study determined the association of promoter DNA methylation of RASSF1A gene with clinicopathological features in tumor and non-tumor tissue. Materials and methodsA cross sectional study was conducted in the Department of Pathology, Government Institute of Medical Sciences, Greater Noida and Molecular Pathology Laboratory, Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences. Two sections, one from tumor and the other from non-tumor tissue, were obtained and processed for DNA extraction and bisulphite conversion. Methylation specific PCR was done and results of RASSF1A promoter methylation were statistically correlated with clinicopathological features. ResultsOf the 27 breast cancer tissue, 22 showed invasive ductal carcinoma, one showed invasive lobular carcinoma, another showed ductal carcinoma in situ and three cases showed malignant phyllodes tumor of breast. DNA promoter methylation was found in all the cases. 93% of tumor tissue samples and 67% of the non-tumor tissue samples were found to be aberrantly methylated. Tumor size and histological grade were found to be significantly (p-val <0.05) associated with the RASSF1A gene promoter methylation. ConclusionA significant association of higher tumor size and tumor histological grade with promoter methylation of RASSF1A gene exists suggestive of its being an important determinant of prognostic staging. This critical event in tumorigenesis may be of clinical utility in assessing breast cancer progression. Micro abstractThe study focuses on the RASSF1A gene promoter methylation and its impact on the clinicopathological features in Indian breast cancer patients highlighting the differences from other genetically different population. We found that RASFF1A gene methylation has significant impact on tumor size and tumor grade. The work carries high significance because it addresses the DNA methylation of tumor suppressor gene in relevance of breast cancer. It may also be the first such report on Indian patients with breast cancer.

Giant Malignant Phyllodes Tumour of Breast- A Clinical Dilemma and Surgical Challenge

Phyllodes tumour is an uncommon tumour of the breast. It is fibroepithelial in origin and mostly benign. Giant phyllodes tumours are described as tumours with size more than 10 cm and are extremely rare. Differentiating malignant and benign tumours pathologically is difficult and needs clinical judgement and high index of suspicion. A 50-year-old female presented with complaint of swelling in the left breast. On further evaluation, it was diagnosed as phyllodes tumour on biopsy. She underwent left mastectomy and excision of pectoralis major muscle due to clinical and radiological suspicion of malignancy. Postoperative histopathology report revealed malignant phyllodes tumour. Cases of giant phyllodes tumour should undergo adequate imaging and image guided biopsy with high index for suspicion for malignancy. They should be operated as per the principles of oncosurgery as there is a high probability of such huge tumours harboring malignancy.

A giant malignant phyllodes tumor of breast post mastectomy with metastasis to stomach manifesting as anemia: a case report and review of literature

BackgroundPhyllodes tumors (PTs) are well known for local recurrence and progression. Less than 10% of these tumors grow larger than 10 cm. Distant metastases have been reported in up to 22% of malignant PTs, with most metastases being discovered in the lungs. PTs of the breast rarely metastasize to the gastrointestinal tract, and reported cases are scarce. To date, a review of the English literature revealed only 3 cases, including our case, of PTs metastasis to stomach.Case presentationAn 82-year-old female patient had 10-year-duration of palpable huge tumor on left breast which was in rapid growth in recent months. Total mastectomy of left breast was performed thereafter, and pathology diagnosis was malignant phyllodes tumor. Adjuvant radiotherapy was suggested while she declined out of personal reasons initially. For PTs recurred locally on left chest wall 2 months later, and excision of the recurrent PTs was performed. She, at length, completed adjuvant radiation therapy since then. Six months later, she was diagnosed of metastasis to stomach due to severe anemia with symptom of melena. Gastrostomy with tumor excision was performed for uncontrollable tumor bleeding.ConclusionFor PTs presenting as anemia without known etiologies, further studies are suggested to rule out possible gastrointestinal tract metastasis though such cases are extremely rare. Management of metastatic gastric tumor from PTs should be done on a case-to-case basis, surgical intervention may be needed if there is persistent active bleeding despite medical treatment. Adjuvant radiotherapy is recommended in borderline and malignant PTs with tumor-free margin < 1 cm and high-risk malignant tumors. Adjuvant chemotherapy or target therapy may be helpful for metastatic PTs. Molecular and genomic techniques may predict clinical outcomes of benign and borderline PTs more precisely.

Phyllodes tumor of breast, real-world data from a referral center in Mexico.

e19356 Background: Phyllodes tumors of breast (PTB) comprise a wide range of rare fibroepithelial neoplasms representing less than 1% of all breast tumors. Studies that describe the clinical characteristics of Mexican women with PTB are scarce. Methods: We performed a retrospective analysis of all patients with newly diagnosed PTB treated at an oncology referral center in Northeast Mexico from 2013 to 2018. Results: Twenty-three women were included in the analysis. Median age at diagnosis was 51 years. Diagnosis was made by self-detection in all cases, with a median tumor size of 12.8 cm. Approximately 26% of patients had a history of benign breast disease. Regarding treatment received 39% underwent radical mastectomy whereas simple mastectomy and breast-conserving surgery were performed in 39 and 22%, respectively. PTB were classified as benign, borderline, and malignant in 17, 13, and 70% of cases, respectively. Patients with malignant PTB showed a heterologous component in 22% of cases (60% with mixed histology, 20% fibromyxosarcoma, and 20% osteosarcoma). Metastatic disease at diagnosis was documented in 3 patients. Relapse of disease was confirmed in eight patients, two of them corresponded with borderline histology and six to malignant subtype. Recurrence sites by frequency were locoregional only 38%; distant disease to the lungs only 12%; and combined metastases to lung, liver and central nervous system 50%. Regarding management of recurrence, four patients received chemotherapy, two received only radiotherapy, one was treated with radiotherapy and chemotherapy and one woman received surgical treatment with adjuvant radiotherapy. Among all patients analyzed, the median overall survival was 23.6 months. Conclusions: To our knowledge, this is one of the first studies analyzing the clinical-pathological characteristics of phyllodes tumors in the Mexican population.

Radiotherapy with apatinib for recurrence of malignant phyllodes tumor of the breast

Rationale:Malignant phyllodes tumors of the breast are rare, and there are currently no guidelines and a large number of clinical trials to guide the treatment of recurrence tumor. Here we reported a case of radiotherapy with apatinib for the treatment of recurrent malignant phyllodes tumor of the breast.Patient concerns:A 58-year-old patient with massive breast mass was admitted to our hospital. Two months after surgical treatment, the tumor recurred in the chest wall scar.Diagnoses:The histopathologic diagnoses was right breast malignant phyllodes tumor with chondrosarcomas and osteosarcomas in some areas.Interventions:The patient was first treated with surgery. Malignant phyllodes tumor recurred in the chest wall two months after surgery and was treated with radiotherapy and apatinib.Outcomes:With surgery, radiotherapy and apatinib treatment, the patient still died within several months.Lessons:Apatinib and radiotherapy failed to obtain good therapeutic effect in the recurrence of breast malignant phyllodes tumor in this case.

Not Every Fat-Containing Lesion on Mammogram is a Benign Finding: Case Report and Review of Breast Malignant Phyllodes Tumor with Heterologous Liposarcomatous Differentiation

Not Every Fat-Containing Lesion on Mammogram is a Benign Finding: Case Report and Review of Breast Malignant Phyllodes Tumor with Heterologous Liposarcomatous Differentiation

Recurrent malignant phyllodes tumor of breast with gastric metastasis

Malignant phyllodes tumor of the breast (MPTB) is a rare breast malignancy. Surgery is the primary treatment for this malignant tumor. Adjuvant radiotherapy should be considered if the surgical margin is positive. The lungs and bone are the most frequent metastatic sites of MPTB; however, gastric involvement is rare. Herein, we report a 64-year-old woman with MPTB. Surgery was the initial treatment; however, lung and gastric metastases were found 5 years later. Palliative chemotherapy with the CyVADIC regimen (cyclophosphamide, vincristine, doxorubicin, and dacarbazine) achieved a partial response. In conclusion, systemic chemotherapy can be one of the treatment options for patients with metastatic MPTB.

Malignant Phyllodes Tumor of Breast with Rapid Growth in Young Female: A Case Report

Malignant Phyllodes Tumor of Breast with Rapid Growth in Young Female: A Case Report

Malignant Phyllodes Tumour of Breast: Case Report and Review of Literature

Malignant Phyllodes Tumour of Breast: Case Report and Review of Literature

Diagnosis and treatment of breast cancer during pregnancy: a review of twelve cases

Objective To investigate the principles of diagnosis and treatment of breast cancer during pregnancy. Methods Clinical data of twelve patients with breast cancer during pregnancy admitted to Peking Union Medical College Hospital between January 1995 and October 2015 were analyzed retrospectively. Follow-up studies on the prognosis of the mothers and infants and the long-term survival were carried out, and data were analyzed with descriptive statistical analysis. Results Of these twelve patients, eleven were diagnosed with breast cancer preliminarily by ultrasound. In the remaining one who presented with paraneoplastic neurological syndrome, breast tumor was discovered by the whole-body positron emission tomography/computed tomography (PET-CT) examination after emergent cesarean section. The mean gestational age at ultrasonic diagnosis in the eleven patients was (26.3±3.0) weeks, and all of them received surgical treatment during pregnancy. The mean gestational age at surgery was (28.2±4.4) weeks. Ten patients with epithelial tumor underwent modified radical mastectomy. One patient with breast malignant phyllodes tumor received local extended lumpectomy. Postoperative pathological staging revealed one patient with stage Ⅰa, two with stage Ⅱa, one with stage Ⅱb, six with stage Ⅲa, and one with stage Ⅲb. The patient with paraneoplastic neurological syndrome was diagnosed as having stage Ⅳ breast cancer, and received chemotherapy, radiotherapy and endocrinotherapy. One patient received chemotherapy during pregnancy. None of the patients received radiotherapy during pregnancy. All twelve patients, except one with breast malignant phyllodes tumor, received postpartum adjuvant therapy. All patients were followed up regularly. Five patients were followed up for more than five years, the progression-free survival rate was 4/5 and the overall survival was 5/5. The other seven patients were followed up for less than five years, the progression-free survival rate was 6/7 and the overall survival was 7/7. Eleven of the twelve patients had live birth. Eleven cases received cesarean section at (36.5±2.8) gestational weeks, and the other one had mid-trimester induction of labor at 27 gestational weeks. Of four premature infants, three were sent to neonatal intensive care unit because of neonatal respiratory distress syndrome, and one died of intracranial hemorrhage. The prognosis of the ten survived infants was good. Conclusions Breast cancer is one of the most common malignant tumors during pregnancy, and it often presents in more advanced stages compared with that in non-pregnant women. Multidisciplinary cooperation and detailed assessment of maternal-fetal risks and benefits are necessary. Key words: Pregnancy complications, neoplastic; Breast neoplasms; Pregnancy outcome

Coexistence of tuberculous axillary lymphadenitis and giant borderline malignant phyllodes tumor of the breast: A rare case report

Cystosarcoma phyllodes are uncommon breast tumors which rarely metastasize to axillary lymph nodes. The tumor is similar to fibroadenoma in structure, but it is different histologically. Although surgery (excision vs. mastectomy) is the mainstay of treatment, the need for adjuvant therapies such as radiotherapy for a malignant variety is unclear. Its association with ipsilateral tubercular axillary lymph nodes has not been reported in literature so far. We report a 35-year-old female that presented with a giant borderline malignant phyllodes tumor of the right breast along with ipsilateral tubercular granulomatous axillary lymph nodes.

Metastatic malignant phyllodes tumor involving the cerebellum

Brain metastases from malignant phyllodes tumors of the breast are a rare occurrence. We report a patient with a malignant phyllodes tumor of the right breast which subsequently metastasized to the right lower lobe of the lung 1year after initial presentation, and to the right cerebellar hemisphere 2years after diagnosis of her breast mass. After both chemotherapy and whole brain radiotherapy the patient is tumor free at most recent follow-up, 116months after the breast tumor diagnosis was made. The literature is briefly reviewed and the differential diagnosis of malignant spindle cell brain tumors is discussed.