Margin dilemma in vacuum-assisted excisional BIOPSY to treat benign phyllodes tumors.

To the Editor,

We read with great interest the article entitled “Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors.” by Shang QJ et al. [1]. They reported that ultrasound-guided vacuum-assisted excisional biopsy is an effective method to treat benign phyllodes tumors, especially in lesions with a diameter less than 3.3 cm.

We appreciate the efforts of the authors in this regard. We would like to express our opinion, based on three important questions.

First, since the lesion was not removed as en-bloc (one piece), how did they detect that the surgical margins were exactly tumor negative? In a tumor that has not been removed in one piece, it is unlikely that pathologists will give information about the surgical margin.

Second, what distance did the authors consider safe for the surgical margin and how did they measure it? The current recommendation of NCCN for benign phyllodes tumor is 1 cm [2,3].

Third, which method did they use to distinguish recurrent tumor and residual tumor during the follow up period?

We would like to emphasize that surgical resection with clear margins is still the most valuable and indispensable method in the treatment of benign phyllodes tumor.

Declaration of competing interest

The author declares that no competing financial interests exist. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.