Breast Desmoid Tumor After Bilateral Breast Reduction: A Case Report

Desmoid tumors are rare soft tissue tumors that can occur at various anatomic sites. Often, patients present with symptoms that are secondary to either external compression or local invasion into nearby structures. While desmoid tumors are rare in the breast, a significant portion of breast desmoid tumors occur in women who have undergone prior breast surgery. We detail a case report of a 60-year-old woman who presented with an enlarging, painful breast mass in the lower outer quadrant of the right breast two years after undergoing bilateral breast reduction for symptomatic macromastia. Furthermore, we reviewed the literature for the treatment of breast desmoid tumors.  The patient underwent diagnostic imaging, biopsy, and multidisciplinary care. Ultimately, she opted for wide local excision, and the margins on permanent pathology were negative with the closest margin being 5mm. With negative margins, no adjuvant radiation was done. She continues to be followed for surveillance and has no clinical or radiologic signs of recurrence at one year after resection.  Breast desmoid tumors are rare and often associated with prior breast surgery. Patients who have undergone elective breast surgery may present to any range of medical providers with a firm breast mass that may or may not be symptomatic. Diagnostic imaging should be pursued to rule out malignancy rather than assume pathology such as fat necrosis. The principles of oncoplastic breast surgery can be used to achieve functional and aesthetic results in the context of wide local excision.