Departments of Breast Surgery, St James' Hospital, Dublin, 8, Ireland.
Department of Breast Surgery, St Vincents Hospital, Dublin, 4, Ireland.
Breast Cancer. 2021 Jan;28(1):168-174. doi: 10.1007/s12282-020-01145-5. Epub 2020 Aug 11.
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.
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.
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.
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.
乳腺纤维瘤病是一种罕见的临床实体，但存在重大的诊断和治疗挑战。鉴于最近管理实践的变化，本研究旨在回顾我们机构在乳腺纤维瘤病方面的经验，并对这种疾病的现有文献进行综述。
在两家三级医疗机构的病理数据库中，对 10 年来（2007-2016 年）诊断为乳腺纤维瘤病的所有患者进行了搜索。记录每位患者的临床病理特征和治疗方式。同时进行了全面的文献检索，确定并回顾了与乳腺纤维瘤病及其治疗相关的研究。
共确定了 16 例患者。诊断时的中位年龄为 42 岁（范围 21-70 岁），所有患者均经核心活检诊断。诊断最有用的影像学检查方法是超声和磁共振成像。16 例中有 13 例接受了手术治疗，而 3 例采用了观察等待的方法。13 例中有 6 例（46%）需要再次切除边缘，13 例中有 2 例（15%）在手术后复发。文献回顾显示，目前尚无专门针对乳腺纤维瘤病管理的指南。由于复发率高和相关手术并发症多，目前倾向于采用“观察等待”方法而非手术干预。所有病例均应在肉瘤多学科团队会议上进行讨论，并应考虑在晚期病例中使用酪氨酸激酶抑制剂。
乳腺纤维瘤病很少见，但会影响年轻患者。由于复发率高和广泛的发病率，主动监测现在优于手术切除。需要制定专门的指南，以确保获得最佳结果。
