AB196. 202. Fibromatosis of the breast—a 10-year institutional experience and review of the literature

Background: Breast fibromatoses are a rare clinical entity but pose significant diagnostic and therapeutic challenges. The aim was to review our institutional experience of management of breast fibromatoses and provide an up-to-date review of current available literature on such management.

Methods: A search of pathological databases within our institution 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 search of MEDLINE/PubMed, Embase, and the Cochrane Library was performed. Studies relating to breast fibromatosis and its management were identified and reviewed.

Results: Seven patients were identified. Median age at diagnosis was 37 (range, 22–70) years and all patients were diagnosed with core biopsy. The most useful imaging modality in diagnosis was ultrasonography (6/7 patients with abnormalities) followed by magnetic resonance imaging. 5/7 were treated surgically whilst 2/7 were treated using a watch and wait approach. Four out of 5 (80%) required re-excision of margins and 1/5 (20%) had recurrence after surgery. On review of the literature, there is no dedicated guideline in place for the management of breast fibromatoses. Currently a watch and wait approach is favoured over surgical intervention due to high levels of recurrence and all cases should be discussed at a sarcoma multidisciplinary team meeting. The use of tyrosine kinase inhibitors should also be considered.

Conclusions: Breast fibromatosis is rare but affects young patients and often requires further surgery. Dedicated guidelines are required to ensure best outcomes.

Keywords: Breast; fibromatosis; management; outcomes