CASE 15009 Published on 23.10.2017
0

Breast fibromatosis

Section

Breast imaging

Case Type

Clinical Cases

Authors

Rodríguez Suárez Israel
Espejo Fonseca Ruby

Instituto de enfermedades de la mama,FUCAM A.C,Breast radiology; Avenida bordo 100 40980 Mexico city; Email:Trovador_yes@hotmail.com
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Israel Rodríguez Suárez Breast Imaging Radiologist Mexico
Patient

38 years, female

Categories
Area of Interest Breast ; Imaging Technique Mammography, PACS
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Clinical History
A 38-year-old woman with a palpable lump.
Imaging Findings
Mammography indicated a spiculated left mass at 9 o'clock, with no suspicious calcifications (Fig. 1).
Ultrasound demonstrated a solid mass with angled, indistinct margins and retraction of Cooper's ligaments. No suspicious lymph nodes were found (Fig. 2).
A BI-RADS category 5 was given.
A core needle biopsy was performed and the histopatological diagnosis was:
Breast fibromatosis (desmoid tumour) (Fig. 3).
Discussion
Breast fibromatosis or desmoid tumour of the breast corresponds to less than 0.2% of mammary tumours.
It is a locally aggressive proliferation, with no potential for metastasis, consisting of fibroblastic and myofibroblastic cells that infiltrate the breast stroma.
It has a high local recurrence rate (29%) due to infiltrative margins.
Clinically and radiologically it is indistinguishable from a carcinoma, the most common presentation is a spiculated mass without associated calcifications or lymphadenopathy.
It may occur spontaneously or be associated with a history of trauma or surgery (augmentation or reduction mammoplasty).
The diagnosis is histopathological: Low-grade spindle cell proliferations composed of interlacing fibroblastic bundles and fascicles with varying degrees of collagen surrounding normal breast parenchyma; expression of beta-catenin, with negativity for high molecular weight cytokeratins and negativity for CD34 being the hallmark.
The treatment is complete surgical excision. [1, 2, 3, 4, 5, 6]
We must remember that a spiculated mass with no calcifications and suspicious lymph nodes with a histologic diagnosis of breast fibromatosis is a concordant radiologic-pathologic correlation.
Differential Diagnosis List
Breast fibromatosis (desmoid tumour).
Metaplastic carcinoma; spindle cell type
Lowgrade fibrosarcoma
Nodular fasciitis
Scar or biopsy site reaction
Final Diagnosis
Breast fibromatosis (desmoid tumour).
Case information
URL: https://eurorad.org/case/15009
DOI: 10.1594/EURORAD/CASE.15009
ISSN: 1563-4086
License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Figure 1

Breast fibromatosis

Breast fibromatosis
MLO view. A spiculated left mass is seen at 9 o'clock, with no suspicious calcifications.
Breast fibromatosis
CC view. A spiculated left mass is seen at 9 o'clock, with no suspicious calcifications.
Breast fibromatosis
MLO view, close up. A spiculated left mass is seen at 9 o'clock, with no suspicious calcifications.
Breast fibromatosis
CC view. Close up. A spiculated left mass is seen at 9 o'clock, with no suspicious calcifications.
Figure 2

Breast fibromatosis 2

Breast fibromatosis 2
Ultrasound: there is a solid mass with angled and indistinct margins, retraction of Cooper's ligaments.
Breast fibromatosis 2
Peripheral vascularity is present.
Figure 3

Breast fibromatosis 3

Breast fibromatosis 3
Photomicrograph from the left breast tru- cut specimen demonstrates low-grade spindle cell proliferations; expression of beta-catenin, consistent with breast fibromatosis.