Surgical management of benign phyllodes tumours of the breast: Is wide local excision really necessary?

Can J Surg. 2018 Dec 1;61(6):17617. doi: 10.1503/cjs.017617.

Abstract

Current guidelines recommending wide local excision (≥ 1 cm margin) for all breast phyllodes tumours regardless of classification are based on retrospective data. Benign phyllodes tumours of the breast are not aggressive. They are often indistinguishable from fibroadenomas on core biopsy and are diagnosed only after excisions without attention to margins. Once the diagnosis is made, the decision to operate and obtain further margins versus wait-and-watch is the dilemma breast surgeons face on a regular basis.

MeSH terms

  • Alberta / epidemiology
  • Breast / pathology
  • Breast / surgery
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Margins of Excision*
  • Mastectomy, Segmental / methods
  • Mastectomy, Segmental / standards*
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / prevention & control
  • Phyllodes Tumor / pathology
  • Phyllodes Tumor / surgery*
  • Practice Guidelines as Topic
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Treatment Outcome
  • Watchful Waiting / standards