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 [1].
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 [2]. 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
If you've had a mammogram before, the radiologist will compare your old mammogram to the new one to look for changes. While they're looking for possible cancer, your doctors may also come across other structures in the breast that deserve further investigation. Calcifications which are tiny flecks of calcium which look like grains of salt located in the soft tissue of the breast that can sometimes indicate the presence of an early breast cancer. Calcifications usually can't be felt, but they appear on a mammogram. Cystsis another mass found in the breast but unlike cancerous tumors which are solid, cysts are fluid-filled masses in the breast. Cysts are very common, and are rarely associated with cancer. Also fibroadenomas can be found these are movable, solid, rounded lumps made up of normal breast cells. While not cancerous, these lumps may grow. And any solid lump that's getting bigger is usually removed to make sure that it's not a cancer. Fibroads are commonly found in young people. {text:bookmark-start} (Breast Cancer, 2007) {text:bookmark-end} There is some much emphasis on breast cancer in woman. Men can also be diagnosed with breast cancer. It is not as common in men as women but it is possible. Male breast cancer is a rare condition, accounting for only about 1% of all breast cancers. The American Cancer Society estimates that approximately 1690 new cases of male breast cancer will be diagnosed
Invasive ductal carcinoma is the most common type of breast cancer. Invasive ductal carcinoma starts in one of the milk ducts in the breast, spreads through the wall of the duct and into the fatty tissue of the breast. Once it has spread outside the duct it is possible to spread to other parts of the body through the lymphatic system and blood stream. Some signs and symptoms of invasive ductal carcinoma can include: a lump in the breast tissue or armpit area, redness, thickening, irritation or dimpling, breast pain and or swelling, and nipple changes and or discharge. (American Cancer Society, 2014., National Cancer
Dermatofibromas (also known as Fibrous histiocytoma and Fibroma simplex, Nodular subepidermal fibrosis, Sclerosing hemangioma), are common noncancerous (benign) small skin growths. Dermatofibromas are typically detected on the arms and legs. Other common areas are located on breast, face and hands. This growth is usually a benign, single structure that resembles a nipple. Its appearance can be discolored and contains hard, scar-like tissue. A minor injury such as an insect bite, puncture or most recently discovered arsenic, can result in the formation of a dermatofibroma. These growths or nodes only can be found on humans and have not been reported or found other animals. It is estimated that only 1:10 women
Breast cancer in males is quite common, yet still many people are unaware of this disease. Often, it can go undiagnosed until the cancer is in the fourth stage. Every year over 2,000 men will be diagnosed, but only 54% will survive. Cancer in men is often overlooked as it is almost 100 times less common in men than women. During a man’s entire lifespan, the risk of having a diagnosis is about one in one-thousand. The most common symptom of this devastating disease are a lump or some swelling. This can be around the breast tissue, nipple, under the arm, or even on the neck. Male breast cancer can spread to the lymph nodes underneath the arm or above the collarbone even before it is noticed on the breast. The lumps are usually painless but
Osteosarcoma is also called osteogenic sarcoma in medical term (“Osteosarcoma”, n.d.). This cancer usually develops in growing bones. Although it can occur at any age, it‘s most commonly found in teenagers and young adults and is slightly more common in males than females. Any bone in the body can be affected, but the most common sites are the arms or legs, particularly around the knee joint(“Osteosarcoma: An Introduction.”, 2012). This cancer is caused by benign tumors and other bone diseases, radiation exposure, genetic factors, children, adolescents, males more than females.(“Osteosarcoma: An Introduction.”, 2012)
Having any of the symptoms in the breast should result in seeing a doctor to fully understand what is going on, and why it is happening.
This paper aims to provide the gaps in our understanding of breast cancer by examining the functions and to enhance our ability to distinguish the anatomy of female human breast. The author also attempts a better understanding of some of the different types of human breast cancer namely: ductal carcinoma in situ, lobular carcinoma in situ, invasive ductal carcinoma and invasive lobular carcinoma. It is hoped that this paper will inform those who do not have the understanding and knowledge about the risk factors, diagnosis, treatments and preventions of the breast cancer.
FOP misdiagnosis can cause a doctor to order biopsies of the bones, which can actually result in exacerbation of lumps.
the American Cancer Society there are benign tumors, which are rare and often develop in
Devil Facial Tumor Disease (DFTD) can be recognized by lumps around the face and neck.
This is despite the increasing clinical relevance of early stage tumors including DCIS, whose incidence has increased from 2% to 25-30% in the past several decades due to widespread use of screening mammography6,7. Although 10-year survival is greater than 98% in the general population6, 11-19% of women with DCIS experience recurrent breast tumors within 10 years of diagnosis6,8. It is unknown whether differences in mortality exist between socioeconomic classes and rural-urban location in women with DCIS. However, recurrent tumors can present as either DCIS or invasive cancer and lead to patient morbidity as well as to more biopsies, re-exploration, increased surveillance, and healthcare utilization in
The results came in confirming a malignant tumor in my mother’s breast, and I knew her hopes had been crushed, but she remained strong. After the surgery, another biopsy established that the cancer was found on the outside of her tumor and also in her lymph nodes, so it was very possible that it could spread. She would need to get a mastectomy.
Ewing's sarcoma is a rare type of cancer that grows in the bones. It is usually found in longer bones of the arms or legs. The thigh bone (femur) is the bone most often affected, followed by the bones of the pelvis, lower leg, upper arm (humerus) and chest.
women normal breast tissue have a density of carcinoma. It very difficult to tell which is
Breast cancer has been acknowledged for centuries, with records dating as far back as the ancient Egyptians, over 3500 years ago (1). However diagnosis, research and progress throughout history have been slow due to it being a matter of taboo and humiliation. In 1957 the idea of surgically removing the tumours was suggested by Henri Le Dran, introducing mastectomy to the 20th century; the first scientific step in acting against cancer. Radical mastectomy lengthened survival, however was often declined due to the disfigurement left behind. To overcome this, Bernard Fisher published results from ‘breast conserving’ surgery accompanied by radiation or chemotherapy, which were ‘just as effective’ as a radical mastectomy (1).