When someone discovers a lump in the breast, it can feel like the world comes to a standstill. While most lumps are non-cancerous, some need careful medical evaluation. Among the lesser-known yet important breast tumors are Phyllodes Tumor and Ductal Carcinoma. Both may seem similar at first—but they are quite different in their nature, treatment, and outcomes.
Let’s walk through a simple comparison to help patients and caregivers understand the differences better.
1. What are these tumors, really?
Phyllodes Tumor
This is a rare type of breast tumor that forms in the connective tissue (stromal cells) of the breast. The name "phyllodes" comes from the Greek word for “leaf,” because under a microscope, the tumor looks like leaf-like patterns. Most phyllodes tumors are benign (non-cancerous), but some can be borderline or malignant (cancerous).
Ductal Carcinoma
This is the most common type of breast cancer and forms in the milk ducts—the passageways that carry milk from the lobules (milk-producing glands) to the nipple. It’s categorized mainly into:
Ductal Carcinoma In Situ (DCIS) –
1. non-invasive, early-stage cancer.
2. Invasive Ductal Carcinoma (IDC) – cancer that has spread beyond the ducts.
2. How do they feel and present?
Phyllodes Tumor
1. Usually presents as a painless, fast-growing lump.
2. Can become quite large if left untreated.
3. Often feels smooth and firm, and may be movable under the skin.
Ductal Carcinoma
1. May also feel like a lump, but could be harder or irregular in shape.
2. Sometimes comes with skin changes, nipple discharge, or dimpling.
3. Can also be found through mammograms before it’s even felt.
3. Who gets them?
Phyllodes Tumor
1. More common in women between 35-55 years.
2. Very rare—accounts for less than 1% of all breast tumors.
Ductal Carcinoma
1. Affects a wider age group, especially women over 50 years.
2. Much more common than phyllodes tumor.
4. Are they cancerous?
Phyllodes Tumor
1. Most are benign, but 10-15% can be malignant.
2. Even benign ones may come back if not completely removed.
Ductal Carcinoma
1. By definition, this is cancer.
2. Can spread to nearby tissue or lymph nodes, especially if invasive.
5. How are they treated?
Phyllodes Tumor
1. Surgical removal is the main treatment. A wide excision is needed to ensure no recurrence.
2. Radiation therapy may be considered if it’s malignant or recurs.
3. Chemotherapy is rarely needed unless it's a high-grade malignant case.
Ductal Carcinoma
Depends on the stage and type but may include:
○ Surgery (lumpectomy or mastectomy)
○ Radiation therapy
○ Chemotherapy
○ Hormonal therapy (if hormone-receptor positive)
○ Targeted therapy
6. What’s the outlook?
Phyllodes Tumor
1. Benign ones have an excellent prognosis after proper surgery.
2. Malignant ones have a moderate risk of recurrence or spread, mainly to the lungs.
3. Follow-ups are essential to monitor any regrowth.
Ductal Carcinoma
1. If caught early (especially DCIS), survival rates are very high.
2. Invasive types require ongoing treatment and monitoring.
Prognosis depends on stage, grade, and response to treatment.
Dr. Pragati Singhal
