Contemporary management of phylloides tumor with vacuum-assisted biopsy: a case report

Abstract

Fibroadenomas are the most frequent benign breast tumors in young women. Phyllodes tumors (PTs) of the breast are uncommon fibroepithelial neoplasms, representing less than 1% of all breast tumors but requiring distinct management due to their unpredictable clinical behavior.  In recent years, vacuum-assisted excision (VAE) has gained popularity as a minimally invasive option that allows for both diagnosis and therapeutic removal of benign lesions with minimal morbidity. We present a case of a 32-year-old female patient with a 20 mm well-defined lesion in the lower outer quadrant of the right breast. Ultrasound imaging exposed typical features of a benign solid mass most consistent to fibroadenoma. A vacuum-assisted biopsy was performed under local anesthesia using an 9G needle. Approximately 90% of the lesion volume was successfully excised. Histological examination revealed a biphasic benign lesion with characteristics of fibroadenoma and focal features consistent with a benign phyllodes tumor. Given the predominantly fibroadenomatous structure and the benign histology, no further surgical intervention was deemed necessary. At 6-month follow-up, ultrasound showed no evidence of regrowth or residual mass, and the patient remained asymptomatic. VAE represents a modern, effective, and patient-friendly approach for managing benign  breast lesions such as fibroadenomas and benign phylloides tumors, particularly those under 3 cm in size.