This very rare breast tumour has been diagnosed in five cases, four females and one male, at our hospital during the last two years. The females all presented tumours with a diameter ranging from 5 to 15 cm. Age at diagnosis ranged from 21 to 54 years. We focus on diagnostic challenges, since 3 of our patients were recently treated by removal of a breast tumour diagnosed morphologically as fibroadenomatosis. Our patients underwent different surgical therapy, and we focus on local treatment modalities advocated in recent literature. Systemic chemotherapy, endocrine treatment and/or radiation therapy, in the adjuvant setting or in advanced disease, do not increase survival in patients with malignant phyllodes tumour.