Question: My daughter is 16 years-old and she noticed one of her breasts was growing larger than the other. I took her to my gynecologist who said she felt a lump and wanted to biopsy it. Since the lump was large they recommended surgery and the pathology report came back as a juvenile fibroadenoma, cannot rule out a low grade phyllodes tumor. The surgeon said because the pathology couldn’t tell if it was a phyllodes tumor or not that to be on the safe side, my daughter needs more surgery to get clear margins. I read a bit on phyllodes tumors and it seems they almost never happen in children so I wonder if the surgery is necessary?

Answer: Phyllodes tumors can unfortunately occur in teen-age girls and if you are interested I can forward you references to studies that have shown that. Sometimes it is very difficult for pathologists to distinguish the difference between a juvenile fibroadenoma and a phyllodes tumor. There aren’t any special tests we can perform, it usually just depends on how much experience the pathologist has with these kinds of tumors. Before you commit to more surgery, I would recommend you find out if the pathologist who diagnosed your daughter specializes in breast pathology or at least has a lot of experience in that area. If not, ask if someone in that pathology department does have more experience with these tumors or get another opinion.