Desmoid fibromatosis of the breast

Summary

Desmoid-type fibromatosis (DTF) is a rare non-metastatic mesenchymal tumour that accounts for only 0.2% of all primary breast neoplasms. This locally aggressive tumour has a high recurrence rate and primarily affects women aged 20-40 years. DTF often presents with features mimicking breast carcinoma, posing diagnostic challenges and the risk of mismanagement. We report a case of a young woman with a left-sided breast mass and skin dimpling. Initial ultrasound and core needle biopsy findings suggested adenosis and intraductal papilloma. Due to the strong clinical suspicion of malignancy, a wide local excision was performed, which confirmed DTF. The patient is currently under surveillance with a regular MRI on follow-up. This case underscores the diagnostic difficulty of DTF, and due to its rarity and limited data, optimal management is debated. Current guidelines favour a conservative 'watch and wait' strategy, with surgery reserved for symptomatic cases. Close follow-up is crucial due to the high risk of recurrence.