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(a) Synthetic 2D mammogram, Mediolateral oblique view right breast showing scattered fibroglandular tissue but no sign of malignancy. (b) DBT shows a small non-specific mass. (c) Synthetic 2D CC view demonstrates a suspicious area but the finding is inconclusive. (d) DBT in CC projection clearly demonstrates a small spiculated mass. (e) Ultrasound showing irregular hypoechoic mass with posterior shadowing, typical of carcinoma.
Source publication
![Fig. 1. (a) FFDM left breast (craniocaudal [CC] projection) shows a...](publication/322598320/figure/fig1/AS:613910398910464@1523379053087/a-FFDM-left-breast-craniocaudal-CC-projection-shows-a-high-density-spiculated-mass_Q320.jpg)
Desmoid tumor of the breast is a rare benign entity that usually is mistaken for carcinoma clinically and radiologically. We report two cases of desmoid tumor of the breast detected by mammography screening using digital breast tomosynthesis (DBT). The larger tumor was detected at both full-field digital mammography (FFDM) and DBT. The smaller desm...
Contexts in source publication
Context 1
... 65-year-old woman was recalled from mammog- raphy screening because of a distortion in the upper medial portion of the right breast not seen at 2D (reconstructed synthetic 2D images) ( Fig. 2a and c) but detected at tomosynthesis ( Fig. 2b and d). There was no history of breast cancer. Clinical examination at work-up was normal without any palpable ...
Context 2
... 65-year-old woman was recalled from mammog- raphy screening because of a distortion in the upper medial portion of the right breast not seen at 2D (reconstructed synthetic 2D images) ( Fig. 2a and c) but detected at tomosynthesis ( Fig. 2b and d). There was no history of breast cancer. Clinical examination at work-up was normal without any palpable ...
Context 3
... mammography includ- ing fine-focus magnification views and cone-down views were performed. The small spiculated mass could not be confirmed at conventional supplemental views but was again only confirmed at DBT. Ultrasound demonstrated a 6-mm irregular hypoechoic mass at 2 o'clock with extensive posterior shadowing highly suspicious of malignancy (Fig. 2e). Ultrasound of the axilla was ...
Context 4
... FFDM images (21). The larger desmoid tumor in our case 1 was easily identified as a spiculated mass on FFDM as well as DBT, since the lesion was located in a fatty part of the breast (Fig. 1a and b). The small subtle desmoid presenting as distortion in case 2, how- ever, was not diagnosed on synthesized 2D mammo- grams but clearly depicted on DBT (Fig. ...
Citations
... On imaging, BDF in mammography presented in this study as irregularly limited malignancy-related masses, partly with spicules and without evidence of microcalcifications. Also in agreement with the previous literature descriptions, sonographically, predominantly hypoechoic and irregular lesions were found in the examined group, partly with concomitant dorsal sound cancellation [25][26][27][28]. All of the tumors met the imaging criteria for a malignancy-related finding. ...
Background:
Desmoid type fibromatoses has proven to be a diagnostic and therapeutic challenge, as they often appear primarily as a carcinoma of the breast with a high recurrence risk.
Patients:
A digital archive search was performed for the period from 2009 to the end of 2018. Inclusion criteria consisted of histological examination of at least the surgical specimen in the reference pathology department and at least a second opinion diagnosis in the reference radiology department.
Results:
A total of 14 women and 1 man underwent surgery on desmoid type fibromatosis of the breast. The average patient age was 49 years (range: 22-72 years). The mean tumor size was 2.2 cm (range: 0.8-4.2 cm). The tumor was detectable in mammography in 12 out of 13 patients and in all 15 patients in sonography. MRI was performed preoperatively in 6 patients; in all of the patients, the tumor was visualized with inhomogeneous contrast enhancement. In the imaging procedures, all desmoid type fibromatoses were classified as suspicious. Performing the core biopsy, preoperative histology confirmed desmoid fibromatosis in 12 out of 15 patients. Nuclear stain for ß-catenin was positive in 7 out of 10 patients. Negative staining was found for AE1/A3 in 10 out of 10 and CD34 in 12 out of 12 patients. In all of the patients, a single-stage operation without the detection of border-forming tumor margins was performed. The follow-up interval ranged from 16 to 96 months (mean: 44.86 months, median: 43 months). In this follow-up period, no patient was diagnosed with desmoid tumor recurrence.
Conclusion:
In imaging, desmoid type fibromatosis of the breast has typical malignancy-related criteria. Extensive preoperative diagnostics enable the planning of complete primary excision of the lesion and reduce the recurrence risk.
Resumen
El tumor desmoide de mama o fibromatosis mamaria es un tumor benigno poco frecuente de extensa proliferación a nivel local, sin potencial metastásico y de elevada recurrencia tras el tratamiento quirúrgico (18-29%). Su etiología es desconocida aunque se ha asociado a poliposis adenomatosa familiar, implantes mamarios de silicona, trauma quirúrgico o fibromatosis familiar multicéntrica. Es más frecuente de los 15 a los 60 años y es dos veces más común en mujeres. Su diagnóstico puede ser complicado por sus similitudes con el carcinoma de mama. Actualmente el tratamiento de elección es la exéresis completa de la lesión con márgenes libres. Se presenta el caso de una paciente de 52 años con una lesión en mama izquierda compatible con tumor desmoide que se confirma tras su extirpación y estudio anatomopatológico, requiriendo ampliación de márgenes.
