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

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

Can J Surg 2018;61(6):430-431 | PDF

Yiming Qian, MD; May Lynn Quan, MD, MSc; Travis Ogilvi, MD; Antoine Bouchard-Fortier, MD, MSc

Summary

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.


Accepted Jan. 22, 2018; Early-released Oct. 1, 2018

Affiliations: From the Department of Surgery, Foothills Medical Centre, the University of Calgary, Calgary, Alta. (Qian, Quan, Bouchard-Fortier); and the Department of Anatomic Pathology, Foothills Medical Centre, University of Calgary, Calgary, Alta. (Ogilvie).

Competing interests: None declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.017617

Correspondence to: A. Bouchard-Fortier, Foothills Medical Centre, 1403 29th St NW, Calgary AB T2N 2T9, antoine.bouchard-fortier@albertahealthservices.ca