Fibromatosis of the breast: A case report and literature review

Abstract

Fibromatosis is an uncommon, relatively benign though locally infiltrating neoplasm consisting of well-differentiated fibroblasts surrounded by collagen bundles. The majority of the literature suggests that prevention of local recurrence mandates wide (en bloc) excision. Few more than a dozen cases of primary breast fibromatosis have been reported. Herein the clinical characteristics, diagnostic evaluation, and therapeutic options are presented. Management should be based upon principles utilized for extra-mammary primary disease-en bloc resection. This may require total mastectomy and removal of pectoralis major muscle. Breast reconstruction should be deferred for a minimum of 3 years, during which time the majority of recurrences will have become manifest.

Aggressive Fibromatosis of Breast: A Rare Case Report

“…2,5,6 Few cases have been associated with Gardner's Syndrome; familial multi centric fibromatosis and familial adenomatous polyposis which suggests a genetic predisposition and probably alteration of the APC/ beta-catenin pathway. 1,2,4,5,7 Patients with mammary fibromatosis almost always present with a painless palpable, firm or hard tumor that suggests carcinoma on clinical examination as the case with our patient. Skin dimpling and retraction are relatively common signs of breast fibromatosis that is likely to reinforce the clinical impression of carcinoma.…”

“…3 As breast fibromatosis do not demonstrate metastatic capabilities, axillary dissection is not performed. 4 A literature review conducted by Trey Thomas et al suggests that patients should undergo quarterly clinical examination for a minimum of three years; as available literature suggests the majority of local recurrences manifest within this time frame. 4 There is no evidence that postoperative radiotherapy, chemotherapy or hormonal treatment is useful as an adjunct to surgery for primary treatment or to control recurrent disease.…”

Management of a female with recurrence of fibromatosis of the chest wall adjacent to the breast: a case report

“…For the treatment of this recurrent tumour, an aggressive surgical resection strategy with a safe margin (2–3 cm) remains the standard therapeutic anoeuvre, which has been strongly advocated by surgeons dealing with fibromatosis of the chest wall that involves the breast [6,7]. The reasons that support this aggressive surgical approach include the potentials of fibromatosis to grow aggressively locally and to invade into the surrounding structures, thus having a high rate of local recurrence when incompletely excised with positive surgical margins.…”

The Value of Fine Needle Aspiration Cytology in Breast Fibromatosis: Study of Two New Cases and Review of the Literature

“…Nuclei are generally bland, with finely dispersed chromatin and inconspicuous nucleoli. Significant variations to this classic pattern have also been reported ranging from nonconclusive specimens (3,5) to paucicellular smears featuring occasional spindle cells and a granular background (4,6,7). Epithelial cells from the trapped glands that have undergone regressive changes may be occasionally recognized: they may exhibit nuclear hyperchromasia, smudging of chromatin, and loss of polarity that may raise the index of suspicion (10) or cause a false‐positive diagnosis (2).…”

“…However, little has been published about its role in proliferative lesions of mammary soft tissue, and only scattered reports are available focusing on fibromatosis, a nonmetastatizing proliferation of soft tissue myofibroblasts. Only a few cases have been studied preoperatively (2–10). Moreover, to the best of our knowledge, fibromatosis has never been documented in a man.…”