Fibromatosis of the breast: a 10-year multi-institutional experience and review of the literature

Breast Cancer. 2021 Jan;28(1):168-174. doi: 10.1007/s12282-020-01145-5. Epub 2020 Aug 11.


Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Breast; Desmoid; Fibromatosis; Surgery.

Publication types

  • Multicenter Study
  • Review

MeSH terms

  • Adult
  • Aged
  • Biopsy, Large-Core Needle
  • Breast / diagnostic imaging
  • Breast / pathology
  • Breast / surgery
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Female
  • Fibroma / diagnosis
  • Fibroma / epidemiology
  • Fibroma / pathology
  • Fibroma / therapy*
  • Humans
  • Magnetic Resonance Imaging
  • Mastectomy / adverse effects
  • Mastectomy / standards
  • Mastectomy / statistics & numerical data*
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / prevention & control
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Practice Guidelines as Topic
  • Reoperation / statistics & numerical data
  • Ultrasonography, Mammary
  • Watchful Waiting / standards
  • Watchful Waiting / statistics & numerical data*
  • Young Adult