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Fibromatosis of the breast: a 10-year multi-institutional experience and review of the literature

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Abstract

Background

Breast fibromatosis is a rare clinical entity, but poses significant diagnostic and therapeutic challenges. In light of recent changes in management practices, the aim was to review our institutional experience of breast fibromatosis and provide a review of current available literature on such management.

Methods

A search of pathological databases within two tertiary institutions for all patients diagnosed with fibromatosis of the breast over a 10-year period (2007–2016) was performed. Clinicopathological characteristics and modes of treatment were recorded for each patient. Concurrently a comprehensive literature search was performed and studies relating to breast fibromatosis and its management were identified and reviewed.

Results

Sixteen patients were identified. Median age at diagnosis was 42 (range 21–70) and all patients were diagnosed with core biopsy. The most useful imaging modality in diagnosis was ultrasonography and magnetic resonance imaging. 13/16 were treated surgically whilst 3/16 were treated using a watch-and-wait approach. 6/13 (46%) required re-excision of margins and 2/13 (15%) had recurrence after surgery. On review of the literature, there is no dedicated guideline in place for the management of breast fibromatosis. Currently a ‘watch and wait’ approach is favoured over surgical intervention due to high levels of recurrence and associated surgical morbidity. All cases should be discussed at a sarcoma multidisciplinary team meeting and tyrosine kinase inhibitors should be considered in advanced cases.

Conclusions

Breast fibromatosis is rare but affects young patients. Active surveillance is now favoured over surgical resection due to high recurrence rates and extensive morbidity. Dedicated guidelines are required to ensure best outcomes.

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Author information

Authors and Affiliations

  1. Departments of Breast Surgery, St James’ Hospital, Dublin, 8, Ireland

    Michael R. Boland, Timothy Nugent, Dhaffir Alazawi, Terence J. Boyle & Elizabeth M. Connolly

  2. Departments of Radiology, St James’ Hospital, Dublin, 8, Ireland

    Johnny O’Mahony & Sylvia O’Keeffe

  3. Departments of Radiation Oncology, St James’ Hospital, Dublin, 8, Ireland

    Charles C. Gillham

  4. Departments of Pathology, St James’ Hospital, Dublin, 8, Ireland

    Aoife Maguire

  5. Department of Breast Surgery, St Vincents Hospital, Dublin, 4, Ireland

    Jack Nolan, James Geraghty, Damian McCartan, Denis Evoy, Ruth S. Prichard & Enda W. McDermott

Authors
  1. Michael R. Boland
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  2. Timothy Nugent
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  3. Jack Nolan
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  4. Johnny O’Mahony
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  5. Sylvia O’Keeffe
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  6. Charles C. Gillham
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  7. Aoife Maguire
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  8. James Geraghty
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  9. Damian McCartan
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  10. Denis Evoy
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  11. Ruth S. Prichard
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  14. Terence J. Boyle
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  15. Elizabeth M. Connolly
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Michael R Boland, Timothy Nugent, Jack Nolan and Johnny O Mahony. The first draft of the manuscript was written by Michael R Boland and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript

Corresponding author

Correspondence to Michael R. Boland.

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Boland, M.R., Nugent, T., Nolan, J. et al. Fibromatosis of the breast: a 10-year multi-institutional experience and review of the literature. Breast Cancer 28, 168–174 (2021). https://doi.org/10.1007/s12282-020-01145-5

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  • DOI: https://doi.org/10.1007/s12282-020-01145-5

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