Phyllodes Tumors: What You Need to Know About Breast Health

Lobular adenoma

Hello Dr.
Yuan: I am 39 years old and have never been pregnant.
Last week, I went for a breast examination due to a hard lump on the inner side of my right breast.
After an ultrasound examination, the doctor informed me that it is a benign "phyllodes tumor," approximately 3 to 4 centimeters in size, which has been present for some time.
I am scheduled for a follow-up in six months.
I searched online for information related to phyllodes tumors but only found information on fibroadenomas and phyllodes tumors, and I couldn't find specific information on phyllodes tumors.
I would like to ask Dr.
Yuan the following questions, and I appreciate your assistance.
Thank you.
1.
What is a phyllodes tumor?
2.
From December 20, 2021, to February 7, 2022, I took Diane to regulate my menstrual cycle due to prolonged periods.
During a hysteroscopic surgery on February 17, 2022, to remove uterine fibroids and cervical polyps, it was found that my endometrium was too thin.
From February 25 to March 8, I took estrogen and progesterone.
Will the phyllodes tumor decrease in size or disappear after stopping progesterone and estrogen? If not, under what circumstances would surgical removal be necessary?
3.
I follow a lacto-vegetarian diet but have had uterine fibroids and now have a phyllodes tumor.
Should I reduce my intake of soy milk and soy products? Can I consume traditional Chinese medicine like Ren Shen and Si Wu Tang? Are there any dietary restrictions I should be aware of?

Elaine, 30~39 year old female. Ask Date: 2022/04/12

Dr. Yuan Tianmin reply Breast and Thyroid

Phyllodes tumors of the breast are actually referred to by the same name as adenomas; the difference lies in the translation used by different physicians.
These tumors can be classified as benign or malignant, and a definitive diagnosis often requires surgical removal for evaluation.
As for dietary restrictions, only patients with breast cancer have specific prohibitions on what they should not eat.
Generally, certain foods may have a stimulating effect on the breast, but these are not considered contraindications for patients who do not have breast cancer.

Reply Date: 2022/04/12

More Info

Understanding Phyllodes Tumors: What You Need to Know About Breast Health
Hello! It’s great that you are taking an active interest in your breast health, especially after being diagnosed with a phyllodes tumor, also known as a cystosarcoma phyllodes. Let’s address your questions one by one.

1. What is a Phyllodes Tumor?
Phyllodes tumors are rare breast tumors that can be benign (non-cancerous) or malignant (cancerous). They originate from the stromal (connective) tissue of the breast and are characterized by their leaf-like architecture when viewed under a microscope, which is how they get their name (phyllodes means "leaf-like" in Greek). These tumors can grow quite large and may cause noticeable lumps in the breast. While they are generally considered benign, they can sometimes metastasize, making regular monitoring essential.

2. Hormonal Influence on Phyllodes Tumors:
Regarding your concerns about the impact of hormonal treatments on the size of the phyllodes tumor, current research suggests that these tumors are not significantly influenced by hormonal changes. Unlike some other breast conditions that are sensitive to estrogen, phyllodes tumors tend to grow independently of hormonal fluctuations. Therefore, stopping estrogen and progesterone therapy is unlikely to cause the tumor to shrink or disappear. Surgical removal is typically recommended if the tumor is large, symptomatic, or shows signs of growth. Regular follow-ups, as your doctor suggested, are crucial to monitor any changes in size or characteristics.

3. Dietary Considerations:
As for your diet, there is no specific evidence linking soy products, such as soy milk and tofu, to the growth of phyllodes tumors. However, since you have a history of uterine fibroids and are currently managing a phyllodes tumor, it may be prudent to moderate your intake of soy products, especially if you notice any changes in your symptoms. Traditional Chinese medicine (TCM) remedies like Si Wu Tang (四物湯) can be beneficial for overall health, but it’s essential to consult with a healthcare provider familiar with both Western and Eastern medicine to ensure that any herbal treatments do not interfere with your current health conditions or treatments.

4. Monitoring and Follow-Up:
Regular monitoring is key in managing phyllodes tumors. You should continue with your follow-up appointments as advised by your healthcare provider. If you notice any changes in the lump, such as increased size, pain, or changes in shape, you should contact your doctor immediately. Self-examinations can also be beneficial; familiarize yourself with the normal feel of your breast tissue so that you can detect any changes early.

5. General Breast Health Tips:
- Maintain a healthy lifestyle with a balanced diet, regular exercise, and adequate sleep.

- Limit alcohol intake and avoid smoking, as these can contribute to various health issues, including breast health concerns.

- Stay informed about your breast health and engage in regular screenings as recommended by your healthcare provider.

In conclusion, while phyllodes tumors can be concerning, many individuals live healthy lives with appropriate monitoring and management. Always feel free to reach out to your healthcare provider with any questions or concerns, as they can provide personalized advice based on your medical history and current health status.

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