Fibromatosis of Breast

Fibromatosis of Breast

Article
Women's Health
Diseases & Conditions
+1
Contributed byMaulik P. Purohit MD MPHNov 08, 2019

What are the other Names for this Condition? (Also known as/Synonyms)

  • Desmoid Tumour of Breast
  • Extra-Abdominal Desmoid Tumor of Breast
  • Mammary Fibromatosis

What is Fibromatosis of Breast? (Definition/Background Information)

  • Fibromatosis of Breast is a rare, primary tumor that arises from within the breast tissue. Even though it is benign, the tumor displays local aggression and can invade into the adjoining tissues
  • Women are affected more during their childbearing phase and less during or after their menopausal phase; the average period of diagnosis is during the middle-age
  • The cause of Fibromatosis of Breast is unknown, but the risk factors may include gender (women are affected more than men) and trauma
  • The signs and symptoms of Fibromatosis of Breast may include lump in the breast and retraction of the nipple. Small-sized tumors may be asymptomatic and show no signs and symptoms
  • Fibromatosis of Breast is treated through a surgical excision, per the healthcare provider’s recommendation. The prognosis is excellent with its complete removal. However, periodic checkups and screening mammograms are advised to be alert for any recurrence

Who gets Fibromatosis of Breast? (Age and Sex Distribution)

  • Fibromatosis of Breast represents approximately 0.2% of all benign breast tumor types
  • The age of presentation of Fibromatosis of Breast in girls and women is between 13-80 years, with an average age of presentation between 40-45 years
  • Men are commonly not affected, however a few incidences have been reported
  • All racial and ethnic groups are affected and no specific predilection is seen

What are the Risk Factors for Fibromatosis of Breast? (Predisposing Factors)

The specific risk factors for Fibromatosis of Breast may include:

  • Women of childbearing age have a higher risk for developing the condition
  • Some studies show that this tumor is associated with trauma

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Fibromatosis of Breast? (Etiology)

  • The exact cause of development of Fibromatosis of Breast is currently not clearly understood
  • Certain gene mutations have also been reported in the tumors. Research is being performed to determine how these mutations contribute to the formation of the tumors

What are the Signs and Symptoms of Fibromatosis of Breast?

The signs and symptoms of Fibromatosis of Breast may include:

  • A benign, solitary lump in a single breast; typically, only one breast is affected and both breasts may not be involved
  • The tumors can appear as a firm, poorly-defined fibrous mass that presents no pain
  • The tumor size may range from a few mm to a 10 cm (average size is 2.5 cm)
  • In some cases, the tumor forms in the chest wall and pushes itself into the breast
  • Inversion of the nipple (pulling-in of nipple into the breast or retraction)
  • Thickening or swelling of part of the breast; change in the size or shape of the breast
  • Discharge from the nipple is seen in rare cases

How is Fibromatosis of Breast Diagnosed?

Fibromatosis of Breast may be diagnosed in the following manner:

  • Complete physical examination with comprehensive medical and family history evaluation
  • Breast exam to check for any lumps or unusual signs in the breasts
  • Mammogram: A mammogram uses x-rays to provide images of the breast. These benign tumors are identified as a mammogram mass, which may or may not be associated with microcalcification. The mammography findings may raise enough suspicion to warrant a tissue biopsy. Based upon the mammographic findings, it is difficult to differentiate between a benign fibromatosis and malignant cancer
  • Galactography: A mammography using a contrast solution, mostly used to analyze the reason behind a nipple discharge
  • Breast ultrasound scan: Using high-frequency sound waves to produce images of the breast, the type of tumor, whether fluid-filled cyst or solid mass type, may be identified
  • Computerized tomography (CT) or magnetic resonance imaging (MRI) scan of the breast
  • Breast biopsy:
    • A biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
    • Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
    • Sometimes, the pathologist may perform additional studies, which may include immunohistochemical stains and molecular studies to assist in the diagnosis

Biopsies are the only methods used to determine whether an abnormality is benign or cancerous. These are performed by inserting a needle into a breast mass and removing cells or tissues, for further examination. There are different types of biopsies:

  • Fine needle aspiration biopsy (FNAB) of breast mass: In this method, a very thin needle is used to remove a small amount of tissue. FNAB cannot help definitively diagnose Fibromatosis of Breast. It only helps determine if the tumor is malignant or benign. This can help the healthcare provider discuss and plan the next steps (with respect to diagnosis and treatment)
  • Core needle biopsy of breast mass: A wider needle is used to withdraw a small cylinder of tissue from an abnormal area of the breast
  • Open tissue biopsy of breast mass: A surgical procedure used less often than needle biopsies, it is used to remove a part or all of a breast lump for analysis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Fibromatosis of Breast?

There may not be any significant complications of Fibromatosis of Breast.

  • Recurrence of the tumor following surgery is observed in 1 in 4 cases (on an average)
  • In some cases, the condition may cause emotional stress due to concerns of a malignancy

How is Fibromatosis of Breast Treated?

The following treatment methods for Fibromatosis of Breast may be considered:

  • A wait and watch approach may be considered for asymptomatic tumors
  • A simple surgical excision and removal of the entire Fibromatosis  of Breast is normally sufficient treatment
    • The surgical procedure performed is known as a breast lumpectomy. It is a surgical procedure to remove the breast lump, which may be done under a general anesthetic
    • During the surgery, a small incision is made in the skin of the breast and a hollow probe that is connected to a vacuum, inserted
    • The breast tissue is sucked through the probe, using vacuum, until the lump has been removed
  • Follow-up care with frequent breast self-examinations and screening mammograms may be recommended by the healthcare provider

How can Fibromatosis of Breast be Prevented?

The development of Fibromatosis of Breast is difficult to prevent. Currently, no specific preventive measures are available to avoid Mammary Fibromatosis.

In general, however, it is important to be aware of certain risk factors for breast tumors, which include:

  • The individual must regularly conduct breast self-exams, to ensure that no lumps are present
  • Maintain a healthy body weight and exercise regularly
  • Implement and follow a well-balanced diet; a high intake of fiber via fresh fruits and vegetables helps in a healthy lifestyle
  • Avoid or completely stop smoking
  • Drink alcohol in moderation; limit to one or (maximum) two drinks a day
  • Limit combination hormone therapy used to treat symptoms of menopause. It is advised that individuals be aware of the potential benefits and risks of hormone therapy

What is the Prognosis of Fibromatosis of Breast? (Outcomes/Resolutions)

  • The prognosis of Fibromatosis of Breast is generally excellent on a surgical excision and removal of the tumor
  • There is a risk of recurrence following treatment, which according to studies, may occur anywhere from within or after 5-6 years. Hence, periodic follow-up check-ups with screening is advised

Additional and Relevant Useful Information for Fibromatosis of Breast:

The following DoveMed website links are useful resources for additional information:

http://www.dovemed.com/healthy-living/womens-health/

http://www.dovemed.com/diseases-conditions/cancer/

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Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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