Oncoplastic Management of a Giant Malignant Phyllodes Tumor: Nipple-Sparing Mastectomy with Immediate Breast Reconstruction
DOI:
https://doi.org/10.34635/rpc.1122Keywords:
Breast Neoplasms/surgery, Lymphatic Metastasis, Mastectomy, Segmental, Nipples/surgery, Phyllodes Tumor/surgeryAbstract
Malignant phyllodes tumors (MPTs) are rare, fast-growing breast neoplasms with a tendency to recur. We report the case of a 44-year-old woman with an 11 cm right breast mass diagnosed as a malignant phyllodes tumor. Due to the tumor’s size and location, she underwent a nipple-sparing subcutaneous mastectomy with immediate implant-based reconstruction. Histopathology confirmed malignancy with high stromal cellularity and a Ki-67 index of 20%; margins were negative. The postoperative course was uneventful aside from minor superficial areolar necrosis. No adjuvant therapy was required. This case illustrates the potential safety and feasibility of nipple-sparing mastectomy with reconstruction in select MPT patients. While wide excision with 1 cm margins remains standard, total mastectomy may be appropriate for large tumors. The case supports the value of individualized, multidisciplinary approaches that integrate oncologic safety with cosmetic outcomes.Downloads
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