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

• Breast Schwannoma
• Mammary Schwannoma

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

• Schwannoma of Breast is a very rare and mostly benign breast tumor that arise from the Schwann cells around the nerves; these tumors are essentially nerve sheath tumors that are mostly seen in older adults
• The cause of formation of these tumors is poorly-understood, but some are known to occur in the setting of a genetic disorder such as familial schwannomatosis or neurofibromatosis type 2
• Schwannoma of Breast tumors may be found incidentally while examining the individual for other medical conditions. The signs and symptoms depend upon the size of the tumors, but it may include breast pain and discomfort
• Typically, a surgical excision of Schwannoma of Breast with its entire removal is the treatment of choice. The prognosis is good on its complete removal in a majority of cases, since it is usually a benign tumor

The following subtypes of Schwannoma of Breast are recognized:

• Cellular Schwannoma of Breast
• Epithelioid Schwannoma of Breast
• Melanotic Schwannoma of Breast
• Plexiform Schwannoma of Breast

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

• Schwannoma of Breast is an uncommon tumor that correspond to less than 3% of all schwannomas. It also constitute less than 1% of all primary breast tumor masses
• Schwannomas, in general, are noted in older adults
• Both males and females can be affected
• No specific ethnic or racial preference is seen

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

Currently, no definitive risk factors are reported for Schwannoma of Breast that is solitary in nature. However, the following factors are suggested when multiple schwannomas are present in the body:

• The presence of neurofibromatosis type 2 (NF2), a genetic condition that is characterized by the formation of non-cancerous tumors that affect the nervous system
• A family history of the tumor
• Familial schwannomatosis: It is a genetic condition that is a usually seen in adults and manifests as multiple schwannomas
• Gorlin-Koutlas syndrome: A complex genetic disorder of multiple tumors in the body including multiple schwannomas
• Carney complex: It is often associated with melanotic schwannomas

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 Schwannoma of Breast? (Etiology)

The exact cause of formation of Schwannoma of Breast is unknown.

• Schwannomas, in general, are known to be the result of sporadic mutations. This implies that they do not have a preceding family history of the condition
• A majority of Mammary Schwannomas occur randomly and are not associated with a genetic syndrome (non-syndromic and sporadic)
• Multiple schwannomas are known to occur in a background of genetic disorders, such as neurofibromatosis type 2 (NF2), Gorlin-Koutlas syndrome, or a positive family history
• In general, the tumor is believed to be caused by the overproduction of Schwann cells that wrap around the nerve

What are the Signs and Symptoms for Schwannoma of Breast?

The signs and symptoms of Schwannoma of Breast depend on the size of the tumor. In general, small tumors are asymptomatic and large tumors can cause signs and symptoms. The signs and symptoms of Mammary Schwannoma may include:

• The tumor may be present as a non-tender mass that is mobile and 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
• The masses are often round to oval in shape
• It is often well-defined and demarcated
• Breast pain and discomfort from large tumors

How is Schwannoma of Breast Diagnosed?

In some, Schwannoma of Breast is diagnosed incidentally during imaging studies undertaken for some 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 Schwannoma of Breast?

The complications of Schwannoma of Breast may include:

• Stress and anxiety due to a concern of breast cancer
• In rare cases, tumors may recur after surgery
• Complications of the underlying genetic syndrome, if any present
• Treatment complications

How is Schwannoma of Breast Treated?

The treatment options vary from one individual to another. The treatment measures for Schwannoma of Breast may include the following:

• Majority of asymptomatic tumors are not surgically removed after the tumor is diagnosed and determined to be benign on a biopsy
• The healthcare provider may recommend a ‘wait and watch’ approach for small-sized tumors presenting mild signs and symptoms, after a diagnosis is made through a fine needle aspiration or a core biopsy
• Surgical (simple) excision and tumor removal may also be considered
• Treatment of the underlying or associated conditions, if any present

Follow-up care with regular screening may be recommended by the healthcare provider

How can Schwannoma of Breast be Prevented?

Current medical research has not established a method of preventing Schwannoma of Breast. In the background of genetic syndromes:

• 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 Schwannoma of Breast? (Outcomes/Resolutions)

The prognosis of Schwannoma of Breast depends upon the severity of the signs and symptoms.

• The prognosis is generally good on tumor removal. Most schwannomas are benign and do not recur when completely excised
• Also, individuals with small-sized tumors have a better prognosis than those with larger-sized tumors
• If benign schwannomas transform to malignant schwannomas (on very rare occasions), then the prognosis may depend upon a set of several factors including the stage of the tumor, overall health of the individual, and response to therapy

Asymptomatic tumors may require no treatment; unless they cause discomfort, affect the quality of life, or affect functioning of the underlying nerve. In such cases, close monitoring of the tumor is a treatment option.

Additional and Relevant Useful Information for Schwannoma of Breast:

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

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

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