in patients with histological-identified malignant tumors. The most common site for distant metastases include the lung, bone, and abdominal viscera. In more insidious cases, the parotid region has also been described in literature. Prevention and Screening There is no evidence-based recommendations for screening or preventative measures for early detection of phyllodes tumors. In patients with a prior history of a phyllodes tumor, the follow-up recommendations are employed on a case-by-case basis depending upon the grade and stage of the treated tumor. Patients who have not had a mastectomy should continue regular breast cancer screening based on the recommendations by the United States Preventative Services Task Force. Treatment The most common, curative treatment for a phyllodes tumor is wide surgical excision with greater than 1 cm margins. Other than surgery, there is no definite cure for a phyllodes tumor as chemotherapy and radiation therapy have not proven effectiveness. The risk of developing local recurrence or metastases is related the histologic grade and mitotic activity of the tumor. Despite proper surgical excision, a high percentage of surgeries performed to treat a phyllodes tumor demonstrate incomplete excision margins that require additional revision surgery. Radiation treatment, after breast-conserving surgery with negative margins, may significantly reduce the local recurrence rate for borderline and malignant tumors. A study performed in 2012 derived a risk calculator for relapse risk of phyllodes tumors after surgery. Prognosis The prognosis of phyllodes tumor is good with an overall 87% 10-year survival rate. After wide-margin surgical excision, 98.7% of benign phyllodes tumors and 80% of borderline were cured. In rare cases where the tumor has metastasized, the prognosis is poor. This most commonly occurs in cases of malignant grade phyllodes tumor. Epidemiology Phyllodes tumors account for approximately 1% of all breast neoplasms. They primarily occur in adult women, with very few examples reported in adolescents. Incidence is most common between the ages of 40 and 50, prior to the onset of menopause. For comparison, this is about 15 years older than the typical age of patients with a fibroadenoma, a common differential diagnosis in patients with a suspected phyllodes tumors. Younger women have a higher chance of having a benign phyllodes tumor, while older women are more likely to have higher-grade tumors. References External links Breast neoplasia