A 35-year-old woman presents with a 2 cm breast lump. Core biopsy shows a fibroepithelial lesion with increased stromal cellularity, 5 mitoses per 10 HPF, and pushing margins. What is the most appropriate management?

• A Observation with follow-up
• B Neoadjuvant chemotherapy
• C Simple mastectomy
• D Wide local excision with a 1 cm margin ✓

Explanation

The features described are consistent with a borderline phyllodes tumor. Phyllodes tumors are managed with wide local excision with a margin of at least 1 cm to prevent local recurrence. Observation is insufficient, mastectomy is reserved for very large or malignant tumors, and chemotherapy is not standard for borderline lesions.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.