The 2025 joint guidelines from the American Society of Breast Surgeons (ASBrS) and the Society of Breast Imaging (SBI) provide much-needed clarity on the management of benign fibroepithelial lesions (FELs), including fibroadenomas and benign phyllodes tumors. The consensus recommends that core biopsy–proven fibroadenomas without atypia require no excision or imaging follow-up unless symptomatic, enlarging, or patient-preferred. In contrast, benign phyllodes tumors or lesions suspicious for phyllodes should undergo complete surgical excision to ensure clear margins.
The guidelines also emphasize aesthetic and functional considerations during surgery and confirm that routine post-excision imaging is unnecessary for benign lesions. This evidence-based framework supports more targeted, patient-centered decision-making and may reduce unnecessary interventions in benign breast disease…
