Phyllodes - borderline

Hello
I'm 60 yo, generally healthy until now. I recently had a biopsy that revealed a 1.5 cm borderline Phyllodes tumor - only borderline because of mitosis count in some areas. I've consulted with an oncologist at a major teaching hospital, who doesn't recommend radiation, only re-excision with wider margins.  He also doesn't recommend chest X-ray.   What is the standard for follow up care in such cases?  On some discussion boards I've read about everything from x-rays, to radiation, to mastectomy.
Wouldn't a chest x-ray be useful as a baseline?  I'd like to get a second oncology opinion - would an breast oncology surgeon be an appropriate person to see?

thank you

[PaulMD]

Hi there.

Tumors like this have a very low malignant potential and I understand your oncologist not requesting a chest X-ray.  However, a chest x-ray may be helpful in assessing your cardio- respiratory function in preparation for a possible operation of the tumor.  These tumors will also not respond to radiation since this has a very low mitotic count and low proliferative index.  The most commonly recommended treatment is indeed wide-excision, with a mastectomy being reserved for large or recurrent tumors.  The surgical oncologist would probably say the same thing and is the right doctor for the job of removing the tumor.

Regards.

[CVGal]

Hi,  thank you very much for your reply.

Can you please explain in layman's terms what is 'low proliferative index'?