Neurofibroma of Breast

Neurofibroma of Breast

Article
Brain & Nerve
Women's Health
+3
Contributed byKrish Tangella MD, MBAFeb 12, 2022

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

  • Breast Neurofibroma
  • Mammary Neurofibroma

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

  • Neurofibroma of Breast is a common benign tumor that mostly appears as a superficial tumor on the breast in both men and women. Neurofibromas are nerve tumors that arise from the nerves underneath the skin surface or subcutaneously
  • The risk factors and cause of development of Neurofibroma of Breast is not well-understood. In most cases, the presence of neurofibromatosis type 1 (NF1) is noted; solitary tumors are not associated with this genetic disorder
  • Neurofibroma of Breast does not present any significant signs and symptoms in most cases. A treatment may be undertaken based on the healthcare provider’s evaluation. In such cases, a simple surgical excision is sufficient treatment. The prognosis is good on its complete removal in a majority of cases, since it is usually a benign tumor

The following subtypes of Neurofibroma of Breast are recognized:

  • Atypical Neurofibroma of Breast
  • Diffuse Neurofibroma of Breast
  • Plexiform Neurofibroma of Breast

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

  • Neurofibroma of Breast is an uncommon tumor that is observed in adults
  • These tumors constitute less than 1% of all breast neoplasms
  • Both males and females can be affected
  • No specific ethnic or racial preference is seen

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

  • An association with neurofibromatosis type 1 (NF1) is observed in most cases of Neurofibroma of Breast. NF1 is a genetic condition that is characterized by skin pigmentation and the formation of non-cancerous tumors that affect the central nervous system
  • A presence of solitary Mammary Neurofibromas that are not seen in a background of NF1 are rare

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's 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 for Neurofibroma of Breast? (Etiology)

The exact cause of formation of Neurofibroma of Breast is unknown but is believed to take place due to genetic mutations.

  • Currently, studies indicate defects in the NF1 gene, and a strong association with neurofibromatosis type 1, which is an autosomal dominant condition, is noted
  • Only a few cases of Neurofibroma of Breast are reported to be sporadic and non-syndromic

What are the Signs and Symptoms for Neurofibroma of Breast?

The signs and symptoms of Neurofibroma of Breast may include:

  • The tumors may be solitary (rarely) or many in number (seen in individuals with NF1)
  • Most tumors are present in the nipple-areola region of the breast
  • The tumor may be present as mobile mass that can be felt by touch (palpable). This means that the tumor can easily be moved within the breast tissue during examination of the breast, as the tumor is not stuck to the overlying skin
  • Tumors on the superficial skin layers of the breast may appear pedunculated
  • The tumor masses are often round to oval in shape
  • It is often well-defined when solitary, and poorly-defined when more than one tumor is noted (multinodular)
  • There may be breast pain and discomfort from large-sized tumors

How is Neurofibroma of Breast Diagnosed?

In some, Neurofibroma of Breast is diagnosed incidentally during imaging studies undertaken for other medical conditions. The diagnosis may involve the following tests and procedures:

  • 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
  • Breast ultrasound scan: Using high-frequency sound waves to produce images of the breast
  • 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
  • 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 for Neurofibroma of Breast?

The complications of Neurofibroma of Breast may include:

  • Stress and anxiety due to breast cancer concerns
  • Cosmetic issues from superficially located tumors
  • Some forms of neurofibroma are known to be precancerous, especially when large nerves are involved, and the presence of neurofibromatosis type 1 is noted
  • Complications of the underlying genetic syndrome, if any present
  • Treatment complications

How is Neurofibroma of Breast Treated?

A Neurofibroma of Breast may require no treatment since it is generally asymptomatic. However, in case these tumors cause discomfort and/or present cosmetic concerns in the individual, they may be removed. The treatment measures adopted may include:

  • The healthcare provider may choose to regularly monitor the tumor if they are asymptomatic
  • A complete surgical excision and removal can result in a cure
  • Treatment of underlying neurofibromatosis type 1 (if present) may be necessary

Follow-up care with regular screening may be recommended by the healthcare provider, particularly in those with underlying NF1.

How can Neurofibroma of Breast be Prevented?

Current medical research has not established a method of preventing Neurofibroma of Breast. In the background of neurofibromatosis type 1:

  • Genetic testing of the expecting parents (and related family members) and prenatal diagnosis (molecular testing of the fetus during pregnancy) may help in understanding the risks better during pregnancy
  • If there is a family history of the condition, then genetic counseling will help assess risks before planning for a child
  • Regular medical screening at periodic intervals with tests and physical examinations are strongly recommended

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

The prognosis of Neurofibroma of Breast is excellent on its complete excision and removal

  • Since, these are benign tumors, the prognosis is excellent, even if no treatment is provided and only periodic observation is maintained (typically, when it is not associated with any genetic syndrome and the tumors are small in size)
  • The prognosis of neurofibromas associated with neurofibromatosis type 1 depends upon the severity of the signs and symptoms of the genetic disorder

Additional and Relevant Useful Information for Neurofibroma 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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Krish Tangella MD, MBA picture
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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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