I had a 2.2 cm phyllodes tumor removed. The surgeon and the pathologist had disagreements about the pathology report on my case. The surgeon made the pathologist re-evaluate my tumor. It was written in the final report that the margins around the tumor that were to be removed, was not sufficient. There is debate now whether or not to redo the surgery to take more tissue as it was not the proposed 10mm margin. In addition, during the OR, I received a strep infection. After the scar was healed, with no signs of infection, 9 days after surgery, a constant trickle of infection started to run out of the scar of the in-cession. I called the surgeon, were I was taken to his office (midnight) and he proceeded to rip the scar open to expose the infection. I was then transfered to a hospital were I was admitted for 5 days. Now, weeks later, I am still healing from the infection and the surgeon has told me that he is unsure of whether or not they will need to do another surgery to remove tissue (due to re-occurrence) as he is not familiar with this type of tumor. He has shown no concern or need for me to be concerned, but with all the things that have gone wrong, I have an overwhelming concern of dread. What should I do? How does one go about getting a second opinion without offending the original surgeon? Is there a need for a second opinion? Should I have contacted an oncologist (which I have not)?
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Q: how important is margins when removing a phyllodes tumor and when should one seek a second opinion?
Swayze, your surgeon's own words that he is not sure how to proceed provide the opening to ask for a referral to a doctor at a comprehensive cancer center or other hospital where more phyllodes tumors have been treated. Because this type of tumor is so rare, your doctor should not feel offended about your asking for a second opinion. Because chemotherapy is not part of the usual treatment for a phyllodes tumor, you probably do not need to see an oncologist. The pathology report is the key to what needs to happen next. Most phyllodes tumors are benign, but if yours was malignant, those margins are more crucial. I'm sorry that you have had so much trouble healing from the surgery. I think you will feel better after seeing another doctor so that you can be confident that enough has been done or make plans for more treatment.
It is important as they can reoccur, mine did three years later. After all you have beenthrough I would find a breast surgeon and wait and see if it reoccurs . If not you can save a needless surgery and if you go for a check up every six months it will not get big
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