Dermatofibrosarcoma In The Breast : Diagnostic And Treatment Dilemmas
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Dermatofibrosarcoma Protuberans in the Breast: Diagnostic and Treatment Dilemmas
Abstract: Dermatofibrosarcoma protuberans (DFSP) is an extremely rare sarcoma, accounting for less than 0.1% of all malignancies and approximately 1% of all soft tissue sarcomas. The overall incidence has been reported between 0.8–5.0 cases per 1 million persons per year. Furthermore, only a few case reports of DFSP have been found within breast tissue .
We report a case of a 30-year-old female with DFSP found within the left breast. It was a palpable, painless and rubbery, mobile lump that was gradually increasing in size. Further workup with ultrasound and MRI core biopsy suggested DFSP.
Current treatment of DFSP in the breast tissue is lacking due to the low incidence reported in the literature. The current recommendations are of surgical excision with 1- 2cm margins . This is not without cosmetic implications, and consequently may reduce compliance to aggressive surgical treatment.
In this case, the surgical aim was for 2cm margins. Adequate margins were achieved except for a medial margin of 5.9mm. Final histology confirmed DFSP. Further discussion in multidisciplinary team and with the patient came to a decision to continue with close observation alone, rather than re-excision. This is predicated on the slow growth pattern of DFSP and its tendency to metastasize only very rarely.
We present this case to discuss the difficulties associated with diagnosis, treatment and