Nodular Fasciitis Of Breast

Introduction

Nodular fasciitis of the breast is a rare benign pathology that can mimic breast cancer clinically, radiologically, and histopathologically. We present a case study of 42-year-old female patient who was referred to our breast clinic with right breast pain for 3 years with no clear palpable masses or skin changes, no nipple discharge was seen. She gave history of trauma on the right breast more than 15 years back. Sonography and mammogram demonstrated a highly suspicious lesion about 3 x 1cm tubular hypoechogenic with associated architectural distortion.

Core needle biopsy of the lump had been performed and result was spindle cell proliferation admixed with blood vessels. The differential diagnosis might include phyllodes tumor and fibromatosis. Wide local excision of tumor was done with k-wire localization. Histopathological result came to be nodular fasciitis of breast. Nodular fasciitis of breast, a rare pathology of breast, can mimic breast cancer and therefore excision was recommended.

Discussion

Back Ground Information

Nodular fasciitis , which was first described by Konwaller is a benign proliferation of fibroblasts in the subcutaneous tissues and commonly associated with fascia. Nodular fasciitis of the breast can mimic breast cancer. It appears as irregular or speculated lesion on mammography and ultrasound. The exact cause of nodular fasciitis of breast is still unknown. It is likely to be triggered by injury, though a history of trauma has been elicited in few cases like our case. Nodular fasciitis of breast require core needle biopsy for histological diagnosis.

The key cytologic features for diagnosis are fibroblast-like spindle cells in a myxoid material, chronic inflammatory cells, capillary proliferation, and vascular channels with extravasated red blood cells. For the treatment of Nodular fasciitis, either conservative management or excisional biopsy can be chosen. A conservative approach is appropriate if the lesion has a typical clinical appearance, with the core biopsy consistent ...