Fibromatosis of the Breast: Case Report and Current Concepts in the Management of an Uncommon Lesion (original) (raw)
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Fibromatosis, a benign breast disease mimicking carcinoma. A case report
International Journal of Surgery Case Reports
INTRODUCTION: Fibromatosis is an uncommon breast lesion that can mimic breast carcinoma in its clinical presentation. CASE SUMMARY: We present a clinical case in which a diagnosis and treatment dilemma existed, in terms of ultrasound findings that were not clear and suspicious, as well as results of Fine needle aspiration cytology. Our findings are compared with previous published cases. Also, literature review regarding fibromatosis presentation and diagnosis has been discussed, as well as treatment options. CONCLUSION: Management of breast fibromatosis remains controversial because of the low incidence and further efforts needed to establish evidence-based treatment guidelines.
Fibromatosis of the Breast: Report of a Case with Cytohistological Correlation
Archives of Breast Cancer, 2022
Background: Breast fibromatosis is a very rare, locally infiltrative lesion, without metastatic potential that arises from either stromal fibroblasts or myofibroblasts of the breast or from the pectoral fascia, extending into the breast, with its cytological and histological features only rarely being described. Case Presentation: A 58-year-old woman, with no past medical/surgical or family history, was diagnosed on regular mammographic and ultrasound examination with a nodular tumor density, in the upper inner part of her right breast. There were no calcifications or apparent lymph nodes in the right axilla. The woman underwent FNA and US-guided biopsy and final resection biopsy under hook marking. We reviewed the cytological findings of fibromatosis of the breast, as they presented in FNAC aspirates of a non-palpable mammographic finding and the histological findings in both preoperative core-needle biopsy and excision specimen. The final diagnosis was of fibromatosis of the breas...
Fibromatosis of the breast: a 10-year multi-institutional experience and review of the literature
Breast Cancer, 2020
Background Breast fibromatosis is a rare clinical entity, but poses significant diagnostic and therapeutic challenges. In light of recent changes in management practices, the aim was to review our institutional experience of breast fibromatosis and provide a review of current available literature on such management. Methods A search of pathological databases within two tertiary institutions for all patients diagnosed with fibromatosis of the breast over a 10-year period (2007-2016) was performed. Clinicopathological characteristics and modes of treatment were recorded for each patient. Concurrently a comprehensive literature search was performed and studies relating to breast fibromatosis and its management were identified and reviewed. Results Sixteen patients were identified. Median age at diagnosis was 42 (range 21-70) and all patients were diagnosed with core biopsy. The most useful imaging modality in diagnosis was ultrasonography and magnetic resonance imaging. 13/16 were treated surgically whilst 3/16 were treated using a watch-and-wait approach. 6/13 (46%) required re-excision of margins and 2/13 (15%) had recurrence after surgery. On review of the literature, there is no dedicated guideline in place for the management of breast fibromatosis. Currently a 'watch and wait' approach is favoured over surgical intervention due to high levels of recurrence and associated surgical morbidity. All cases should be discussed at a sarcoma multidisciplinary team meeting and tyrosine kinase inhibitors should be considered in advanced cases. Conclusions Breast fibromatosis is rare but affects young patients. Active surveillance is now favoured over surgical resection due to high recurrence rates and extensive morbidity. Dedicated guidelines are required to ensure best outcomes.
Dynamic Breast MRI in Recurrent Fibromatosis
American Journal of Roentgenology, 2005
year-old woman with recurrent breast fibromatosis. A, Contrast-enhanced coronal subtracted MR image reveals rapidly and heterogeneously enhancing irregular mass. B, Graph of MRI time-signal intensity curves from MR image shows type II (plateau) and type III (washout) curves.
Mammary Fibromatosis: Case Report and Review of the Literature
MOH Journal of Medical Case Reports, 2024
Breast fibromatosis (BF) is a rare, low-grade infiltrative spindle cell neoplasm from the breast connective tissue composed of fibroblasts and myofibroblasts. It is benign but has locally aggressive proliferation within the breast. It accounts for less than 0.2% of all breast tumors. Clinically, it often presents as a firm, painless, and immobile mass, which can be mistaken for malignancy due to its infiltrative growth pattern. In breast pathology, distinguishing between various conditions is crucial for effective diagnosis and appropriate treatment. Two such conditions that are often confused are BF and breast desmoid tumor (BDT). While they may share similarities, understanding their differences is essential for accurate medical management. BF arises from the fibrous connective tissue within the breast. However, BDT originates from deep fascial planes within the breast and exhibits an infiltrative growth pattern into surrounding tissues, analogous to soft tissue desmoids elsewhere in the body. It is generally accepted to consider BDT a more infiltrating form of BF. We present a case of a 38-year-old woman diagnosed with BF, and we review the relevant literature.
Breast fibromatosis: Making the case for primary vs secondary subtypes
The Breast Journal, 2019
Fibromatosis of the breast is a rare extra-abdominal desmoid tumor that typically lacks metastatic potential, but can be locally aggressive and lead to failure of loco-regional control if not adequately treated. Reports of fibromatosis of the breast are often discussed only in case reports and small case series. The consensus on treatment remains wide local excision; however, other therapies have been described. In discussion of an interesting case presentation of what we have defined as secondary breast fibromatosis, we reviewed relevant treatment modalities and discussed proper treatment for this patient. Our aims of this review of breast fibromatosis were fourfold. First, we present an interesting case report of a secondary breast fibromatosis with an aggressive surgical resection strategy. Second, we prompt a comprehensive discussion of fibromatosis with a review of the literature. Third, we offer the delineation between primary and secondary breast fibromatosis and determine if the behavior of the two is different. Finally, we present a case series. Overall, this comprehensive review highlights past and present recommendations in the treatment of this locally aggressive disease.
Fibrocystic change of the breast presenting as a focal lesion mimicking breast cancer in MR imaging
Journal of Magnetic Resonance Imaging, 2008
Focal fibrocystic change (FCC) of the breast is a rare form of FCC. Imaging presentations of focal FCC are not well known. This study aimed to analyze its MR imaging features. Eleven patients of pathology-proven focal FCC were retrospectively studied. Of the 11 patients, 7 were mass (≥5mm), 2 showed multiple foci, and 2 were focus (< 5mm). The lesion size ranged from 4mm to 12mm (mean 6.7mm). Morphologically, 3 patients were suspected as malignancy. Using kinetic enhancement curve, 8 of 13 lesions were suspected to be malignant. Overall, 9 patients (82%) were suspected for malignancy using either criterion. Using mammography, 6 of the 11 patients (55%) were diagnosed as malignancy. Breast sonography suspected malignancy in 7 patients (7/10, 70%). No statistically significant difference was found in the three diagnostic methods. In pathology, all 11 patients showed the typical pathological features of fibrocystic change, with mixed components of stromal fibrosis, cyst formation, apocrine metaplasia, adenosis, and/or focal sclerosing adenosis. In conclusion, MR imaging features of focal FCC usually present as a mass or focus lesion with rapid enhancement and washout kinetics, which mimic a malignant breast lesion and lead to unnecessary operation, especially in patients with contra-lateral malignant breast cancer.
Fibrocystic Changes of the Breast: Radiologic–Pathologic Correlation of MRI
Journal of Breast Imaging, 2021
Breast MRI provides high sensitivity but modest positive predictive value for identifying breast cancers, with approximately 75% of MRI-guided biopsies returning benign pathologies. Fibrocystic change (FCC) is a descriptive term used colloquially by many radiologists (and falling out of favor with many pathologists) to refer to several benign entities encountered in the breast. Many of the benign entities believed to comprise FCC can show enhancement on MRI. Recognizing the pathologic correlates of these enhancing lesions should help guide management after such a result on MRI-guided biopsy. Premenopausal women may present with clinical symptoms attributed to FCC, including pain, nipple discharge, breast lumps, or discrete masses. Benign entities associated with FCC include proliferative lesions such as usual ductal hyperplasia and sclerosing adenosis, and nonproliferative lesions including cysts, apocrine metaplasia, and stromal fibrosis. Fibrocystic change can be diffuse or focal....
Aggressive Fibromatosis of Breast: A Rare Case Report
Fibromatosis, a locally aggressive but non-metastasizing neoplastic proliferation of fibroblastic cells, commonly encountered in the abdominal wall and extra-abdominal sites but rarely occurs in the breast. Here we report a case of aggressive fibromatosis of breast, which presented as a palpable mass in the right breast of a 53-year-old female. The physical examination revealed a 12x10 cm sized ovoid mass in the right upper outer quadrant. Ultrasonogram demonstrated an 8x5 cm sized hypoechoic mass with peripheral increased vascularity on doppler imaging. Wide local excision was done and pathology revealed aggressive fibromatosis.
Journal of radiology case reports, 2012
Breast fibromatosis is a rare entity responsible for 0.2% of all solid breast tumors. It has been associated with scars, pregnancy, implants, and familial adenomatous polyposis. We present an interesting case of breast fibromatosis in a 29 year old woman which encroached upon her saline implant and subsequently filled its cavity once the implant was removed. The patient was put on tamoxifen therapy and at 14 month follow-up there was a significant decrease in the size of the mass. Dynamic MRI images are offered for review and current treatment options are discussed.