Fibromatosis of the breast

We have reviewed the Columbia-Presbyterian Hospital experience with fibromatosis of the breast, a most uncommon lesion that frequently mimics carcinoma. Very few examples of this rare lesion have been reported previously, and the lack of follow-up data has made it difficult to evaluate treatment. Five patients were cared for at the Columbia Presbyterian Medical Center and an additional 12 patients were reviewed after slides were sent for consultation. Complete clinical information and follow-up data were obtained in a total of 13 patients, three of whom had recurrences. There were no histologic features that served to distinguish those patients who had a recurrence from those who did not. While there were no recurrences when adequate excision was carried out, it is worth noting that we found one instance of spontaneous regression as well as two patients who did well despite the fact that tumor was found at the margin of the specimen. The results of this review suggest that the major problem facing the surgeon, once the diagnosis has been made, relates to the difficulty in defining the extent of the tumor in the breast. Careful orientation of the specimen and repeated use of frozen sections should make it possible to perform a complete excision and, at the same time, remove a minimum amount of breast tissue. Since fibromatosis is a benign process, the cosmetic impact of surgical therapy certainly deserves careful consideration.