Benign Phyllodes Tumor

I was diagnosed after biopsy surgery with a benign phyllodes tumor on my right breast " consists of a 3x2.5x1.6 cm tan lobular segment of fibrofatty tissue...A well defined, obvious mass is not encountered...The cellular fibroglandular lesion sits at the cauterized edge of this biopsy. I would favor it represents a cellular fibriadenoma, although a phyllodes tumor would be in the histologic differential...The lesion does sit at the surgical margin of this biopsy....;Margin of tumor: fibrocystic changes". A second opinion requested by the pathologist reads: " Submitted slides from needle core biopsies of right breat show a fibroepithelial tumor similar to that seen in the subsequent excisional biopsy specimen...From an excisional biopsy of right breast show a benign phyllodes tumor. The tumor is characterized by relative stromal hypercellularity and heterogeneity, elongated epithelial-lined clefts and ill defined edges. Mitotic activity is not prominent. Biopsy site changes are present. The lesion extends to the inked margin of resection....slides labelled b (margin) show inactive fibrous breast tissue."
My doctor informed me that it was not necesary to do another surgery even if he had not "removed the margins". From the literature, I am not sure if this surgery is required/recommended. For my peace of mind I would like to know which treatment is recomended for this type of tumor? What are the statistics of phyllodes tumors recurring or increasing malignancy if the margins were not removed?  Who should I go for a second opinion? Do benign phyllodes have the potential of malignancy...Are they considered cancerous even if benign...My doctor said NO but this contradicts alot of what is available on the internet.

Thanks

[PaulMD]

Hi there.

Benign phylloides tumors would require just wide excision and this rarely recurs or spreads.  The margins of your tumors only shows fibrocystic changes and no phylloides tumor so I guess this is the reason why your doctors are already confident with the surgical procedure done already.  This lesion is not treated with radiation or chemo, for surgery is the only effective treatment.  

There are malignant phylloides tumors and there are benign phylloides tumors.  There is no hard evidence that benign phylloides tumors will undergo malignant transformation in the future.

However, I still suggest you continue with your regular check ups with your doctors.  Regards and God bless.