Treatment of cystosarcomaphvlloides -

Ans. is 'a' i.e., Mastectomyo Treatment of cystosarcoma phyllodes -T/T of small phyllodes tumour -* It should be locally excised with an obvious 1cm of normal breast tissue. .After excision, when the diagnosis of a phyllodes tumor with suspicious malignant elements is made, re-excision of the biopsy site to ensure complete excision of a tumour with a 1 cm margin of normal-appearing breast-tissue is indicated.T/T of large phyllodes tumour -* simple mastectomyo Remember, cystosarcoma phyllodes does not metastasize by lymphatic route, so axillary dissection is not needed,o Cystosarcoma phyllodes metastasize exclusively by blood borne route.Other questions on cystosarcoma phyllodesPathologically it is similar to fibroadenoma i.e., proliferation of both duct and stroma is seen.The tumor displays a range of behaviour from benign like fibroadenoma to frankly malignantMammographic evidence of calcifications and morphologic evidence of necrosis do not distinguish between benign, borderline, and malignant phyllodes tumors. Consequently, it is difficult to differentiate benign phyllodes tumors from the malignant variant and from fibroadenomas.Peak incidence is in the fifth decade, exceedingly rare in adolescents.The excised specimen is firm and rubbery and may separate into leaflike structures therefore the term (phyllodes - means leaf like)They usually present as a large growth which is mobile and commonly there is a history of rapid growth.