Ludwig Duazo-Cassin1, Sophie Le Guellec2, Amélie Lusque3, Elodie Chantalat1, Marick Laé4,5, Philippe Terrier6, Jean-Michel Coindre7, Bérénice Boulet8, Morwenn Le Boulc'h8, Dimitri Gangloff9, Thomas Meresse9, Benoit Chaput9, Amal Al Ali10, Françoise Rimareix11, Sylvie Bonvalot12, Charlotte Vaysse13. 1. Département de Chirurgie Gynécologique et Oncologique, Centre Hospitalier Universitaire-Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France. 2. Département de Pathologie, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France. 3. Département de Biostatistiques, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France. 4. Département de Pathologie, Institut Curie, Paris, France. 5. Service de Pathologie, Centre Henri Becquerel, INSERM U1245, UNIROUEN, Université de Normandie, Rouen, France. 6. Département de Pathologie, Gustave Roussy, Université Paris-Saclay Villejuif, Villejuif, France. 7. Département de Pathologie, Institut Bergonié, Bordeaux, France. 8. Département de Radiologie oncologique, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France. 9. Service de Chirurgie Plastique, Reconstructive et des brûlés, Centre Hospitalier Universitaire-Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France. 10. Département de Chirurgie Générale et Digestive, Centre Hospitalier Universitaire Toulouse, Toulouse, France. 11. Département de Chirurgie Plastique, Institut Gustave Roussy, Paris, France. 12. Département de Chirurgie Oncologique, Unité Sarcome, Institut Curie, Paris, France. 13. Département de Chirurgie Gynécologique et Oncologique, Centre Hospitalier Universitaire-Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France. vaysse.charlotte@iuct-oncopole.fr.
Abstract
PURPOSE: Desmoid tumors (DTs) are rare tumors that originate from myofibroblastic tissue. Recently, initial wait and see was recommended (ESMO guidelines Ann Oncol 2017) in the most frequent locations. This study investigates the outcome of breast desmoid tumor (BDT) according to the initial strategy. METHOD: Data from all consecutive patients treated from a BDT in four referral centers were collected. Only intra-mammary desmoid tumors were included. A pathological review and a molecular analysis (CTNNB1 gene mutation) were performed (National re-reading network of sarcomas-RRePS). Patients were grouped according to initial strategy: surgery group (SG) and active surveillance group (ASG). RESULTS: A total of 63 patients (61 women, 2 men) met the inclusion criteria. Median age was 50 years (16-86). CTNNB1 mutation was found in 61% (n = 36). SG included 46 patients (73%) (41 partial mastectomies, 2 mastectomies, and 3 mastectomies associated to parietectomies). Surgical margins were positive in 15 patients (33.3%). Median follow-up of SG was 24.9 (0.5-209) months; and 4 patients (8.7%) developed recurrence. ASG included 17 patients (27%). Their median follow-up was 42.2 (0-214) months, and 15 patients (88.2%) did not require any additional treatment. Six patients (35%) had a spontaneous regression, 9 patients (52%) were stable, and 2 patients presented a significant progression that was treated by partial mastectomy. CONCLUSION: This study supports an initial nonsurgical approach to BDTs followed by surgery based on tumor growth in select cases, which is consistent with current ESMO recommendations.
PURPOSE:Desmoid tumors (DTs) are rare tumors that originate from myofibroblastic tissue. Recently, initial wait and see was recommended (ESMO guidelines Ann Oncol 2017) in the most frequent locations. This study investigates the outcome of breast desmoid tumor (BDT) according to the initial strategy. METHOD: Data from all consecutive patients treated from a BDT in four referral centers were collected. Only intra-mammary desmoid tumors were included. A pathological review and a molecular analysis (CTNNB1 gene mutation) were performed (National re-reading network of sarcomas-RRePS). Patients were grouped according to initial strategy: surgery group (SG) and active surveillance group (ASG). RESULTS: A total of 63 patients (61 women, 2 men) met the inclusion criteria. Median age was 50 years (16-86). CTNNB1 mutation was found in 61% (n = 36). SG included 46 patients (73%) (41 partial mastectomies, 2 mastectomies, and 3 mastectomies associated to parietectomies). Surgical margins were positive in 15 patients (33.3%). Median follow-up of SG was 24.9 (0.5-209) months; and 4 patients (8.7%) developed recurrence. ASG included 17 patients (27%). Their median follow-up was 42.2 (0-214) months, and 15 patients (88.2%) did not require any additional treatment. Six patients (35%) had a spontaneous regression, 9 patients (52%) were stable, and 2 patients presented a significant progression that was treated by partial mastectomy. CONCLUSION: This study supports an initial nonsurgical approach to BDTs followed by surgery based on tumor growth in select cases, which is consistent with current ESMO recommendations.
Entities:
Keywords:
Active surveillance; Breast; Desmoid tumor; Fibromatosis; Surgery
Authors: Michael R Boland; Timothy Nugent; Jack Nolan; Johnny O'Mahony; Sylvia O'Keeffe; Charles C Gillham; Aoife Maguire; James Geraghty; Damian McCartan; Denis Evoy; Ruth S Prichard; Enda W McDermott; Dhaffir Alazawi; Terence J Boyle; Elizabeth M Connolly Journal: Breast Cancer Date: 2020-08-11 Impact factor: 4.239
Authors: Jörn Lorenzen; Miriam Cramer; Nina Buck; Kay Friedrichs; Kirsten Graubner; Clara Sonja Lühr; Christoph Lindner; Axel Niendorf Journal: Breast Care (Basel) Date: 2020-05-28 Impact factor: 2.860