fibromatosis of the breast

Fibromatosis
of the breast: a mimic of cancer. Oblique lateral (A) and craniocaudal incidences (B) revealed focal density with spiculated margins in the right axillary tail of Spence, not seen on B and only partially depicted on A; coarse calcifications. BIRADS 4B
www.eurorad.org • CC by-nc-sa-4.0
Fibromatosis
of the breast: a mimic of cancer. Circumscribed, hypoechoic mass with angular margins and slightly posterior acoustic shadowing. BI-RADS 4B
www.eurorad.org • CC by-nc-sa-4.0
Fibromatosis
of the breast: a mimic of cancer. Circumscribed, hypoechoic mass with angular margins and slightly posterior acoustic shadowing. BI-RADS 4B
www.eurorad.org • CC by-nc-sa-4.0
Fibromatosis
of the breast: a mimic of cancer. Core needle biopsy of the lesion.
www.eurorad.org • CC by-nc-sa-4.0
Fibromatosis
of the breast: a mimic of cancer. Axial T2W image showing spiculated mass, hypointense on T2W with rapid and avid contrast uptake, that was suspected to have accompanied involvement of the minor pectoralis muscle. BI-RADS 4C
www.eurorad.org • CC by-nc-sa-4.0
Fibromatosis
of the breast: a mimic of cancer. Axial Postcontrast Fat-suppressed T1W image showing spiculated mass, hypointense on T2W with rapid and avid contrast uptake, that was suspected to have accompanied involvement of the minor pectoralis muscle. BI-RADS 4C
www.eurorad.org • CC by-nc-sa-4.0
Fibromatosis
of the breast: a mimic of cancer. Sagittal Postcontrast Fat-suppressed T1W image showing spiculated mass, hypointense on T2W with rapid and avid contrast uptake, that was suspected to have accompanied involvement of the minor pectoralis muscle. BI-RADS 4C
www.eurorad.org • CC by-nc-sa-4.0
Fibromatosis
of the breast: a mimic of cancer. Subtraction 4 minutes after injection of contrast image showing spiculated mass, hypointense on T2W with rapid and avid contrast uptake, that was suspected to have accompanied involvement of the minor pectoralis muscle. BI-RADS 4C
www.eurorad.org • CC by-nc-sa-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Fibromatosis of the breast (also known as an extra-abdominal desmoid tumor of the breast or mammary fibromatosis ) is considered as a type of rare breast tumor. It is a non-metastasizing benign but locally invasive stromal tumor . However, it can mimic more sinister types of breast cancer on both imaging and clinical findings .

Epidemiology

They account for only 0.2% of all breast tumors .

Clinical presentation

A desmoid tumor appears as a solitary, hard and painless nodule, which sometimes can be attached to the skin or to the pectoral muscle fascia.

Pathology

The entity is pathologically indistinguishable from fibromatosis occurring elsewhere in the body. The tumor has a fibroblastic and myofibroblastic origin.

Associations

Recognized associations include:

Location
  • while it can occur anywhere in the breast, lesions may tend to occur in close proximity to pectoral muscles

Radiographic features

Mammography

A spiculated, irregular, non-calcified mass is considered the most common mammographic finding.

Breast ultrasound

Fibromatosis typically appears as a solid, spiculated or microlobulated, irregular hypoechoic mass with straightening and tethering of Cooper ligaments, which is very difficult to differentiate from a malignant lesion.

Breast MRI

Usually seen as an irregular breast mass.

  • T1: mammary fibromatosis may appear as ill-defined, hypo- to isointense masses
  • T2: usually heterogeneously hyperintense in signal
  • T1 C+ (Gd): often show suspicious, slow enhancement after contrast administration 

MRI is often useful to show chest wall involvement in selected cases prior to surgical planning.

Treatment and prognosis

Although it is a benign non-metastasizing tumor, it can be locally aggressive. Wide local excision with clear margins remains the treatment of choice . Recurrence rates can be high, especially in those with positive margins. Recurrence is less likely if a wide excision is performed and resection margins are made sure to be disease-free. Recurrences are also often treated with radical excision, like the primary tumor.

See also

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Fibromatose der Mamma:
Gardner-Syndrom
 
www.eurorad.org • CC by-nc-sa-4.0
Mammakarzinom
 
Wikipedia • CC BY-SA 3.0
Brustimplantat
 
Wikipedia • CC BY-SA 4.0
fibromatosis
 
Wikipedia • CC BY-SA 3.0
fibrosarcoma
of the breast
surgicalcasereports.springeropen.com • CC-by-4.0