Phyllodes Tumour — SCE Medical Oncology MCQ

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ModerateBreast CancerPhyllodes TumourSCE Medical Oncology

A 55-year-old woman presents with a rapidly growing breast mass. Core biopsy shows a phyllodes tumour (borderline). What is the recommended surgical management?

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Correct answer: A — Wide local excision with ≥1 cm margins — axillary surgery is NOT required

Phyllodes tumours are fibroepithelial neoplasms classified as benign, borderline or malignant. Surgical management requires wide excision with ≥1 cm clear margins (wider than for breast carcinoma) to reduce local recurrence risk. Axillary surgery is NOT indicated as phyllodes tumours do not spread via lymphatic drainage (haematogenous spread occurs in malignant phyllodes). If margins cannot be achieved with BCS, mastectomy is required. Adjuvant radiotherapy may be considered for malignant phyllodes.

Reference: NICE NG101; ESMO 2024 Phyllodes Tumour Guidelines; WHO Classification