Phyllodes tumor of the breast with the following features is classified as malignant: stromal overgrowth, >10 mitoses per 10 HPF, marked stromal atypia, and infiltrating margins. What is the recommended surgical margin for malignant phyllodes?
- A No ink on tumor (R0)
- B 1 mm clearance
- C At least 1 cm clearance ✓
- D Mastectomy is mandatory regardless of tumor size
Correct answer: C. At least 1 cm clearance
Explanation
Malignant phyllodes tumors require wide local excision with at least 1 cm of clear margins to reduce local recurrence risk; smaller margins (like 1 mm) are acceptable for benign and borderline variants. Mastectomy is preferred when 1 cm margins cannot be achieved without unacceptable cosmetic results, but is not mandatory for all malignant phyllodes. Axillary dissection is not routinely recommended as nodal metastases are uncommon.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.