Functional and Aesthetic Thorax Reconstruction after Desmoid Tumor Resection

Olvera-Caballero, Carlos; Leon, Eric Acosta-Ponce de; Sánchez-Sosa, Sergio

doi:10.1097/gox.0000000000001248

Cited by 1 publication

(2 citation statements)

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“…Desmoid tumors can originate anywhere within the body but are most common in the trunk and extremities. 13 Desmoid tumors are known to arise from muscular fascia or aponeurosis 1,14 and are also believed to arise within the pectoralis major muscle fascia or Cooper ligament. 14 Jewett, in 1979, suggested that when desmoid tumors are associated with breast implants, they could arise from the fibrous capsule that forms around the implant.…”

Section: Discussionmentioning

confidence: 99%

“…In three of the case reports reviewed, [16][17][18] a second desmoid tumor developed at a surgical site remote from the implant, and Case 2 from our series developed a secondary and fibroproliferative disorders of the mesenchymal tissue has been hypothesized. 13 The Wnt/beta-catenin signaling pathway plays an important role in tissue repair, and mutations within the CTNNB1 gene encoding beta-catenin have been found in 85% of sporadic desmoid tumors 13,19 Remarkably, the rate of CTNNB1 mutations is lower in breast desmoid tumors, being around 77%. 20 Moreover, the APC protein suppresses CTNNB1 transcription, explaining the association between FAP-where the APC gene is mutated-and desmoid tumors.…”

Section: Discussionmentioning

confidence: 99%

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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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