Introduction/Background Phyllodes tumours are an uncommon group of fibro-epithelial lesions of the breast, with a low risk of local recurrence and metastasis. These tumours are classified as benign, borderline or malignant according to several histological characteristics.

Benign phyllodes tumours are difficult to differentiate from cellular fibroadenomas due to overlapping microscopic features. Phyllodes tumours are treated by surgical removal. However, there is no consensus on the definition of an appropriate surgical margin to ensure completeness of excision and reduction of the risk of recurrence.

Methodology We report a retrospective study of 26 patients, registered at the CHU HASSAN II of Fez, between 2022 and 2023, admitted for management of a breast nodule classified as ACR4 on mammography.

Results The mean age of the patients was 29.3 years. The average size of the nodule was 2.8 cm, clinically palpable and most often in the form of an opacity classified as ACR4a on mammography.

Biopsy of the nodule showed doubt as to whether it was an adenofibroma or a phyllodes tumour.

All our patients underwent wide lumpectomy.

The anatomopathological results were as follows: 61% grade 1 phyllodes, 6% grade 2 phyllodes, 33% adenofibromas.

2 of the patients with low-grade phyllodes had non-healthy margins and underwent revision surgery.

Post-operative management was straightforward, and the patients are currently under clinical and radiological surveillance every 6 months.

Conclusion Phyllodes tumours are uncommon tumours. The clinical and para-clinical presentation is not very specific and the diagnosis of other fibro-epithelial tumours is often advanced, particularly adenofibroma.

A diagnosis of certainty is histological after complete surgical excision.

Post-therapeutic surveillance is necessary because of the risk of recurrence.

Disclosures The authors declare no conflicts of interest.