title: Toward a new strategy in desmoid of the breast?
abstract: OBJECTIVE
  To report initial results of observation as well as surgery in patients with desmoid tumors (DTs) of the breast, a rare tumor for which data are scarce.
  
  
  METHODS
  The initial approaches were categorized as either front-line loco-regional treatment [(surgery or radiotherapy group, SRG) n = 20] or initial observation [(no surgery/no radiotherapy group, NSRG) n = 11].
  
  
  RESULTS
  A total of 27 women and 4 men were assessed between 1992 and 2013 and included in this study. Patient characteristics were adequately balanced in the 2 groups. Fifteen patients (48.4%) had a past history of breast surgery in the previous 24 months. The median initial DT size on MRI was 50 mm. The median follow-up was 36 months. In the SRG, 8/20 patients (40%) experienced recurrence. The median time to recurrence was 29 months. During the study period, 6 patients in the SRG (30%) received a mastectomy at the time of diagnosis (n = 3) or at relapse (n = 3), 7 patients (35%) received a thoracic wall resection and 8 patients (40%) received radiotherapy at the time of diagnosis (n = 2) or at recurrence (n = 5). In the NSRG, the median tumor size change was -4 mm (range -13 to +20). Three patients changed treatment strategies during the observation period; one received surgery, and 2 were administered anti-hormonal treatment.
  
  
  CONCLUSIONS
  Loco-regional treatments of breast DTs resulted in undesired disfigurement. Front-line observation yielded encouraging results and could enable the identification of patients who require loco-regional treatment. This strategy needs further evaluation.
authors: Department of Surgical Oncology, Sarcoma Unit, Gustave Roussy Cancer Center, Grand Paris, France.
authors: S
authors: S
authors: Roussin
authors: Department of Surgical Oncology, Breast and Plastic Surgery Unit, Gustave Roussy Cancer Center, Grand Paris, France.
authors: C
authors: C
authors: Mazouni
authors: Department of Surgical Oncology, Breast and Plastic Surgery Unit, Gustave Roussy Cancer Center, Grand Paris, France; Department of Surgical Oncology, Sarcoma Unit, Gustave Roussy Cancer Center, Grand Paris, France.
authors: F
authors: F
authors: Rimareix
authors: Department of Surgical Oncology, Sarcoma Unit, Gustave Roussy Cancer Center, Grand Paris, France.
authors: C
authors: C
authors: Honoré
authors: Department of Pathology, Gustave Roussy Cancer Center, Grand Paris, France.
authors: P
authors: P
authors: Terrier
authors: Department of Medical Oncology, Sarcoma Unit, Gustave Roussy Cancer Center, Grand Paris, France.
authors: O
authors: O
authors: Mir
authors: Department of Medical Oncology, Sarcoma Unit, Gustave Roussy Cancer Center, Grand Paris, France.
authors: J
authors: J
authors: Dômont
authors: Department of Radiation Oncology, Gustave Roussy Cancer Center, Grand Paris, France.
authors: C
authors: C
authors: Le Péchoux
authors: Department of Medical Oncology, Sarcoma Unit, Gustave Roussy Cancer Center, Grand Paris, France.
authors: A
authors: A
authors: Le Cesne
authors: Department of Surgical Oncology, Sarcoma Unit, Gustave Roussy Cancer Center, Grand Paris, France. Electronic address: sylvie.BONVALOT@gustaveroussy.fr.
authors: S
authors: S
authors: Bonvalot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001940:Breast / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D018567:Breast Neoplasms, Male / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D018450:Disease Progression; D005260:Female; D018222:Desmoid Tumors / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000601:surgery*; D011878:Radiotherapy; D047368:Tumor Burden; D057832:Watchful Waiting; D055815:Young Adult
keywords: Aggressive fibromatosis; Desmoid; Radiotherapy; Surgery; Treatment