A nonrandom association of breast implants and the formation of desmoid tumors

Costa, Philippos Apolinário; Marbin, Staci; Costa, Bruna Menon Loureiro Apolinario; Espejo-Freire, Andrea P.; Saul, Eduardo Edelman; Barreto-Coelho, Priscila; Allen, Ahkeel; Hakim, Muhammad Omar; Goel, Neha; D’Amato, Gina Z.; Subhawong, Ty K.; Trent, Jonathan C.

doi:10.1111/tbj.14276

Cited by 7 publications

(6 citation statements)

References 29 publications

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“…Interestingly, an association with breast implants and the development of fibromatosis has been described. 35 In our cohort, none of the 2 patients known to have surgery for breast implants developed fibromatosis.…”

Section: Discussionmentioning

confidence: 77%

Mammary Spindle Cell Proliferations on Core Needle Biopsy

Pun

Turashvili

Mulligan

et al. 2023

American Journal of Surgical Pathology

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Mammary spindle cell proliferations (SCPs) encompass a wide range of lesions and can be challenging to accurately diagnose on core needle biopsies (CNBs). Most SCPs are excised for definitive diagnosis. In the era of minimally invasive therapy, some SCP may be followed conservatively. We aim to examine the spectrum of SCP diagnosed on CNB and evaluate if excision of benign/indeterminate SCP is always required. We identified patients with SCP across 3 institutions. The CNB were classified into benign, indeterminate, or malignant. Available excisional specimens were used to classify the lesion as benign or malignant. Clinical variables were reviewed. A total of 197 SCP met the inclusion criteria, including 100 (53%) CNB classified as benign, 52 (26%) indeterminate, and 36 (19%) malignant. Nine patients had excisions without a preceding CNB. Excision was performed in 47% of benign, 87% of indeterminate, and 86% malignant CNB. Of 123 excised SCP, 77 (63%) were benign, while 44 (36%) were malignant. Most benign lesions were not suspicious radiologically (67%), while indeterminate and malignant lesions were more likely to be suspicious (44% and 75%, respectively; P < 0.001). Malignant lesions tended to present as larger, rapidly growing, masses. Most mammary SCP are benign (63% of excisions). Appropriate ancillary tests can safely exclude some malignant entities. We encourage narrowing down the differential diagnosis to pertinent entities based on clinical presentation, imaging, histology, immunohistochemistry, and molecular studies, if applicable. Patients with mammary SCP may be spared surgery provided accurate pathologic diagnosis and appropriate correlation with imaging and clinical data.

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Section: Discussionmentioning

confidence: 77%

Mammary Spindle Cell Proliferations on Core Needle Biopsy

Pun

Turashvili

Mulligan

et al. 2023

American Journal of Surgical Pathology

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“…The standardized incidence ratio (SIR) was calculated to examine if there was a connection between breast implants and breast desmoid tumors. The SIR was 482 to 823, correlating to a 482-823 times higher risk of developing a breast desmoid tumor after breast implant placement compared to the general population (7).…”

Section: Discussionmentioning

confidence: 98%

“…The initial treatment for all desmoid tumors is active surveillance as the majority of tumors will remain stable in size. In one case series 88% of patients had stability of disease or regression (7). Other options for non-surgical treatment include non-steroidal anti-inflammatory medications, hormone therapy (tamoxifen), and chemotherapy.…”

Section: Discussionmentioning

confidence: 98%

“…In a study by Costa et al (7), a total of eighty patients with breast desmoid tumors in the setting of prior breast implants at their institution and other cases reported in the literature were analyzed. Patients underwent the following treatments: 82% had a surgical resection; 12% underwent chemotherapy; 4% received Sorafenib; 14% received hormonal therapy; and 4% underwent active surveillance.…”

Section: Discussionmentioning

confidence: 99%

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Large Desmoid Tumor in the Setting of Prior Cosmetic Breast Augmentation

Krupa¹,

Hu²,

Mootz³

et al. 2022

EJBH

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“…The main risk factors for DF are trauma and surgery and it is estimated in literature that 30% of DF cases occur in such context ( 7 ). Breast implants have also been identified as another important risk factor ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Bilateral breast desmoid-type fibromatosis, case report and literature review

Hennuy¹,

Defrère²,

Maweja³

et al. 2022

Gland Surg

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Background: Breast desmoid-type fibromatosis (BDF) is a rare mesenchymal tumor accounting for only 0.2% of solid breast tumors. It is classified as an intermediate tumor because it is locally aggressive but has no metastatic potential. Its diagnosis is often difficult because it shares many clinical and radiologic aspects with breast carcinomas and therefore relies on anatomopathological analysis which may be supplemented by genetic analysis. The treatment of BDF has considerably evolved in the past years. While surgery was the cornerstone of the management prior to the 2000s, recent data have shown the value of active surveillance (AS) from the time of diagnosis. Indeed, after 2 years of AS, the progression-free survival (PFS) of the disease is identical or superior to surgery. Moreover, spontaneous regression has been observed in 30% of patients undergoing AS. In case of disease progression, surgery can be considered on a case-by-case basis, as well as systemic treatments.Case Description: We present a case of bilateral BDF affecting a 20-year-old woman for whom the first suggested treatment was bilateral mastectomy with reconstruction. After a second opinion, the decision was revised and AS was initiated. Almost 3 years after the onset of AS, tumors have shown a continuous regression.Conclusions: This case demonstrates the need for experience in the management of mesenchymal tumors to avoid overtreatment by mutilating surgeries which promote recurrence. Moreover, to our knowledge, very few cases of bilateral BDF have been published to date. It thus seemed relevant for us to report this rare case which supports the interest of AS for DF, as recently advised by the Desmoid Tumor Working Group guidelines.

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A nonrandom association of breast implants and the formation of desmoid tumors

Cited by 7 publications

References 29 publications

Mammary Spindle Cell Proliferations on Core Needle Biopsy

Mammary Spindle Cell Proliferations on Core Needle Biopsy

Large Desmoid Tumor in the Setting of Prior Cosmetic Breast Augmentation

Bilateral breast desmoid-type fibromatosis, case report and literature review

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