For phyllodes tumor excision, what is recommended?

• A. Simple lumpectomy
• B. Wide excision
• C. Routine biopsy only
• D. Radiation therapy first

Answer: (B)

When removing a phyllodes tumor, the goal is to achieve negative surgical margins because these tumors can extend microscopically beyond what is seen as a lump. A simple lumpectomy that removes only the mass often leaves behind tumor cells at the edges, leading to a higher chance of local recurrence. Therefore the recommended approach is wide local excision, taking a rim of normal tissue around the tumor to ensure clear margins (often around 1 cm, though exact width may depend on the case). Routine biopsy alone would not remove the tumor, and radiation therapy is not used as the initial treatment; it may be considered afterward in certain malignant or high-risk situations, but not as the primary management.