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

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.