A case of nodular fascitis of the breast and review of the literature

Breast Nodular Fasciitis: A Comprehensive Review

“…Spontaneous resolution is also reported in series including other than breast lesions [8]. It seems that resolution does not depend on the size of the lesion; Brown and Carty [6] described a 5.5 cm lesion spontaneously and rapidly regressed. Nevertheless, it is difficult to establish the appropriate criteria for a correct decision between excisional biopsy and conservative management.…”

“…Twenty-two cases included in 20 papers, published in the period under investigation, were analyzed in detail [4,5,6,7,8,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25]. The main demographic and clinical characteristics of the enrolled patients are summarized in table 1.…”

“…Nevertheless, it is difficult to establish the appropriate criteria for a correct decision between excisional biopsy and conservative management. A non-operative approach should be considered in typical cases with clinical, imaging and biopsy features, as those described before [6,24]. If the criteria for such an approach are not met, US-guided vacuum or surgical excision should be provided to establish definitive diagnosis and to cure.…”

“…Generally, it is detected in the soft tissue of the extremities, of the trunk and the neck, although involvement of muscles, fasciae and parenchymatous organs was described, and virtually all parts of the body can be affected [2,3]. The pathogenesis is currently unknown, although the majority of the authors agree that it consists of a reactive proliferative process triggered by local injury, despite only 10-15% of them mentioning it [2,4,5,6]. Nodular fasciitis usually affects the young and middle aged individuals, with a balanced male/female ratio, and is rare in the elderly [3,7].…”

“…The disease is clinically characterized by sudden onset and rapid growth of a unilateral small and firm nodule, often painless and palpable, resembling a malignant neoplasm. Such clinical manifestations, along with the poor specificity of imaging and cyto-histological features, hinder the differential diagnosis and negatively impacts the therapeutic strategy, which must be as conservative as possible, given the benign nature of the disease and the tendency toward spontaneous regression [6,8,9,10,11]. …”