Breast desmoid tumor management in France: toward a new strategy

Duazo-Cassin, Ludwig; Guellec, Sophie Le; Lusque, Amélie; Chantalat, Élodie; Laé, Marick; Terrier, Philippe; Coindre, Jean‐Michel; Boulet, Bérénice; Boulc'h, Morwenn Le; Gangloff, D.; Méresse, T.; Chaput, Benoît; Ali, Amal Al; Rimareix, Françoise; Bonvalot, Sylvie; Vaysse, Charlotte

doi:10.1007/s10549-019-05245-5

Cited by 32 publications

(55 citation statements)

References 32 publications

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“…Notably, there was no relapse in our study population over a median follow-up interval of 43 months. A possible explanation for this result is that all 15 patients with negative margins underwent primary wide excision of the tumor and did not therefore need further surgery, with otherwise comparable tumor sizes and patient ages that were otherwise comparable to those in the study of Duazo-Cassin et al [11].…”

Section: Discussionsupporting

confidence: 53%

“…A primary nonsurgical approach with active monitoring of the patient is recommended in ESMO guidelines since 2017, as evaluations showed no progress or regression in desmoid patients in up to 88% of cases [8, 9, 11, 12]. The prerequisite is the unambiguous core biopsy assurance of the findings and close follow-up controls by MRI examinations [8-12].…”

Section: Discussionmentioning

confidence: 99%

“…In the rare case of a desmoid type fibromatosis of the breast, a recent first large cohort study from Duazo-Cassin et al [11] showed that 15 out of 17 patients with primary active monitoring did not require further therapy. On the other hand, the group of 46 patients undergoing primary surgery in this study showed only a low recurrence rate of 8.7% (4 patients).…”

Section: Discussionmentioning

confidence: 99%

“…According to the current consensus from existing research, e.g., of the Desmoid Tumor Working Group and ESMO, active primary surgical therapy is no longer the method of choice for asymptomatic patients [8, 9]. In the more recent literature on desmoid type fibromatosis of the breast an active surveillance approach showed progression-free courses or remissions in up to 88% of patients [10, 11].…”

Section: Introductionmentioning

confidence: 99%

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Desmoid Type Fibromatosis of the Breast: Ten-Year Institutional Results of Imaging, Histopathology, and Surgery

Lorenzen¹,

Cramer²,

Buck³

et al. 2020

Breast Care

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Background: Desmoid type fibromatoses has proven to be a diagnostic and therapeutic challenge, as they often appear primarily as a carcinoma of the breast with a high recurrence risk. Patients: A digital archive search was performed for the period from 2009 to the end of 2018. Inclusion criteria consisted of histological examination of at least the surgical specimen in the reference pathology department and at least a second opinion diagnosis in the reference radiology department. Results: A total of 14 women and 1 man underwent surgery on desmoid type fibromatosisof the breast. The average patient age was 49 years (range: 22–72 years). The mean tumor size was 2.2 cm (range: 0.8–4.2 cm). The tumor was detectable in mammography in 12 out of 13 patients and in all 15 patients in sonography. MRI was performed preoperatively in 6 patients; in all of the patients, the tumor was visualized with inhomogeneous contrast enhancement. In the imaging procedures, all desmoid type fibromatoses were classified as suspicious. Performing the core biopsy, preoperative histology confirmed desmoid fibromatosis in 12 out of 15 patients. Nuclear stain for ß-catenin was positive in 7 out of 10 patients.Negative staining was found for AE1/A3 in 10 out of 10 and CD34 in 12 out of 12 patients. In all of the patients, a single-stage operation without the detection of border-forming tumor margins was performed. The follow-up interval ranged from 16 to 96 months (mean: 44.86 months, median: 43 months). In this follow-up period, no patient was diagnosed with desmoid tumor recurrence. Conclusion: In imaging, desmoid type fibromatosis of the breast has typical malignancy-related criteria. Extensive preoperative diagnostics enable the planning of complete primary excision of the lesion and reduce the recurrence risk.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Desmoid Type Fibromatosis of the Breast: Ten-Year Institutional Results of Imaging, Histopathology, and Surgery

Lorenzen¹,

Cramer²,

Buck³

et al. 2020

Breast Care

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“…Por lo que se abre una nueva posibilidad de actuación, que todavía requiere de más estudios para poder seleccionar a las candidatas idóneas. 15 No es necesaria la disección axilar, salvo que exista invasión directa del tumor a esta área, ni se ha estandarizado todavía la necesidad de terapia adyuvante. Tratamientos como la quimioterapia y/o la radioterapia, pueden considerarse en el caso de tumores irresecables o que no se hayan podido extraer en su totalidad, 16 o en el caso de recidivas múltiples.…”

Section: Discussionunclassified

Fibromatosis mamaria. Reporte de dos casos clínicos y revisión bibliogáfica

Álvarez

Sánchez-Méndez

et al. 2019

Rev. chil. obstet. ginecol.

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Calle Jesús del Valle nº15 4ºA1, 28004 Madrid. RESUMENIntroducción y objetivos: La fibromatosis produce tumores benignos pero localmente agresivos, que afectan a los tejidos blandos. A nivel mamario, representa tan sólo el 0.2% de las neoplasias de la mama. Nuestro objetivo con el presente artículo es profundizar en el conocimiento de la fibromatosis mamaria, a través del estudio de dos casos clínicos, mostrando sus características clínico-radiológicas e histológicas, e intentar establecer un protocolo de actuación adecuado. Métodos: Estudio retrospectivo de dos casos clínicos de fibromatosis mamaria diagnosticados en el Hospital Universitario La Paz entre los años 2018 y 2019. Resultados: Presentaremos dos pacientes con diagnóstico de fibromatosis mamaria, ambas debutaron con la autopalpación de un nódulo mamario. Al realizarles una ecografía, se visualizó un nódulo sólido, mal definido y axila ecográficamente negativa, que precisó de biopsia-aspiración con aguja gruesa. En los dos casos, se decidió resección quirúrgica de la lesión. Seguimiento mediante exploración mamaria y pruebas de imagen periódicas. Conclusiones: Aunque se trata de una entidad benigna, la fibromatosis mamaria puede simular un proceso maligno, tanto clínica como radiológicamente, por lo que precisa de un estudio histológico. A pesar de que la diseminación metastásica es muy poco frecuente, no se debe olvidar el carácter agresivo a nivel local de esta patología, y sus altas tasas de recurrencia. Como tratamiento, se debe realizar una resección quirúrgica, aunque recientemente se ha contemplado la opción de vigilancia estrecha sin tratamiento. No existe evidencia científica que justifique la utilización de otros tratamientos como la radioterapia o el tratamiento hormonal. PALABRAS CLAVE:Fibromatosis, tumor desmoide, nódulo mamario.ABSTRACT REV CHIL OBSTET GINECOL 2019; 84(5): 384 -392 385

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Ultrasound characteristics of breast fibromatosis mimicking carcinoma

Su,

Huang,

et al. 2023

J of Clinical Ultrasound

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PurposeTo explore the value of ultrasound (US) characteristics in diagnosing breast fibromatosis (BF) and evaluate their differences from breast carcinoma.MethodsA total of 121 patients with BF (n = 24, 29 lesions) or invasive ductal carcinoma (IDC) (n = 97, 102 lesions) of the breast were included. Their clinical and US findings were recorded and analyzed.ResultsThe mean age of BF was younger than that of IDC (28.75 ± 5.55 vs. 50.19 ± 9.87, p < 0.001). The mean size of the BF was smaller than that of IDC (2.09 ± 0.91 vs. 2.71 ± 1.20, p = 0.011). Compared to IDC, BF had more frequency of posterior echo attenuation (p < 0.001), less frequency of peripheral hyperechoic halo (p = 0.002), calcification (p = 0.001), US reported axillary lymph node positive (p = 0.025), and grade 2–3 vascularity (p < 0.001). The Breast Imaging Reporting and Data System categorized BF at a lower level than IDC (p < 0.001). After adjusting for age, the peripheral hyperechoic halo, posterior echo feature, and vascularity could independently identify the differences between these two entities.ConclusionSome differences were observed between BF and IDC in terms of patient age, lesion size, and US characteristics.

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Breast desmoid tumor management in France: toward a new strategy

Cited by 32 publications

References 32 publications

Desmoid Type Fibromatosis of the Breast: Ten-Year Institutional Results of Imaging, Histopathology, and Surgery

Desmoid Type Fibromatosis of the Breast: Ten-Year Institutional Results of Imaging, Histopathology, and Surgery

Fibromatosis mamaria. Reporte de dos casos clínicos y revisión bibliogáfica

Ultrasound characteristics of breast fibromatosis mimicking carcinoma

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