Desmoid Tumor and Silicone Breast Implant Surgery: Is There Really a Connection? A Literature Review

Tzur, Rotem; Silberstein, Eldad; Krieger, Yuval; Shoham, Yaron; Rafaeli, Y.; Bogdanov-Berezovsky, Alex

doi:10.1007/s00266-017-0948-2

Cited by 19 publications

(25 citation statements)

References 37 publications

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“…However, their relationships with Gardner syndrome, previous trauma, and surgery have been described [1-5]. Furthermore, silicone implants are listed as a possible cause in the literature, although intraoperative trauma is more likely to be causative [22, 23]. In the group investigated in this study, ipsilateral breast surgery was performed prior to the diagnosis of BDF in one third of the patients.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…2 Breast desmoid tumors are even rarer, representing only 0.2% of all breast tumors and 4% of all extra-abdominal desmoid tumors. 3,4 The development of a desmoid tumor after the placement of a breast implant is limited to a few case reports and small case series. Thus, the precise incidence has yet to be established.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Background: Studies suggest that surgical breast augmentation with implants is a risk factor for breast desmoid tumors. The statistical strength of this correlation is unknown, as evidence is limited to anecdotal reports. Methods:Patients with breast desmoid tumors and a history of breast implants seen at a single center between 2000 and 2021 were identified via radiology, breast, and sarcoma databases. The standardized incidence ratio (SIR) was calculated to assess the correlation between breast desmoid tumors and breast implants. The cases were pooled with published cases for analyses. Progression-free survival curves and hazard ratios were estimated using the Kaplan-Meier method and Cox proportional-hazards modeling.Results: Fourteen patients from one institution and 66 cases in the literature were identified. All patients were female, and the mean age was 38 years old (range 20-66). 63 patients (82%) underwent resection, 9 (12%) received chemotherapy, 3 (4%) received sorafenib, 11 (14%) received hormonal therapy, and 3 (4%) underwent active surveillance. After resection, the 2-year recurrence-free survival rate was 77% (95% CI 65%-89%). The recurrence risk was lower for resection with no residual tumor (R0) compared to microscopic (R1) or macroscopic (R2) residual tumor (HR: 0.15; 95% CI 0.02-0.8; p < 0.05). The SIR was 482 (95% CI 259-775) to 823 (95% CI 442-1322), suggesting a 482-823 times higher risk of developing a breast desmoid tumor after breast augmentation than the general population. Conclusion:We present a nonrandom association between breast implants and desmoid tumors. Whether the tumors arise from the surgical trauma or the implant's biomaterial is unknown. When surgery is indicated, negative margins reduce the risk of recurrence.

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“…Aggressive fibromatosis could occur in the abdominal wall, intra-abdominal region, and extraabdominal region. According to reported cases, aggressive breast fibromatosis was sporadic, accounting for fewer than 10% of all aggressive fibromatosis (3,4). The etiology of aggressive breast fibromatosis remains uncertain, but the disease may be related to previous trauma, surgery (especially breast augmentation), and some inherited diseases (such as familial adenomatous polyposis).…”

Section: Introductionmentioning

confidence: 99%

“…The etiology of aggressive breast fibromatosis remains uncertain, but the disease may be related to previous trauma, surgery (especially breast augmentation), and some inherited diseases (such as familial adenomatous polyposis). Its incidence accounts for 0.2% of all primary breast neoplasm, and the local recurrence rate is about 29%, mostly occurring within three years after surgery (3,5,6).…”

Section: Introductionmentioning

confidence: 99%

Aggressive breast fibromatosis with axillary accessory breast mastitis mimicking carcinoma: a case report

Huang¹,

Shao²,

Shi³

et al. 2021

Transl Breast Cancer Res

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Aggressive fibromatosis, also referred to as desmoid-type fibromatosis or desmoid tumor, is an uncommon locally invasive tumor with a high local recurrence rate. It rarely occurs in the breast and the etiology of aggressive breast fibromatosis is still unknown but may be related to previous mammary trauma or surgery. Preoperative diagnosis of aggressive breast fibromatosis is still a challenge for clinicians. The optimal treatment for the disease is still controversial, but wide surgical excision with negative margins is considered the standard option. We report a 28-year-old woman of aggressive breast fibromatosis accompanied with accessory breast mastitis in her ipsilateral axilla. The lesions imitated breast carcinoma with axillary lymph node metastasis due to their similar clinical and imaging manifestations. Her mammary mass finally underwent wide surgical excision, and negative margins were confirmed during the surgery. To our knowledge, this is an extremely rare case accompanied with axillary accessory breast mastitis and will contribute to the management of aggressive breast fibromatosis.

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Desmoid Tumor and Silicone Breast Implant Surgery: Is There Really a Connection? A Literature Review

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 19 publications

References 37 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

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

Aggressive breast fibromatosis with axillary accessory breast mastitis mimicking carcinoma: a case report

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