Cystosarcoma phyllodes (CP), otherwise known as phyllodes tumour (PT) of the breast, is a very rare but locally aggressive fibroepithelial tumour in its malignant form, and accounts for 0.3-1% of all breast neoplasias. Using 4 cases reports with different histological classifications as examples (benign-borderline-malignant), we describe the (differential) diagnosis and treatment options of this tumour entity and give an additional review of the available literature.