Mammary fibromatosis mimicking recurrent breast cancer: radiological findings

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Sir: A 61-year-old female was diagnosed with invasive ductal carcinoma in the left breast in February 2000. She underwent left wide local excision and axillary nodal dissection. Lymphnodes were negative for metastases. The patient received chemotherapy as well as radiotherapy to the preserved left breast. She was under postoperative imaging follow-up. Bilateral mammography in March 2001 revealed a spiculated density without calcifications under the surgical scar of the left breast that correlated with post-surgical changes. Suspect breast lesions were not found on clinical examination. The mammogram performed in February 2002 showed the same findings but the density in the left breast seemed to increase in size. The sonography showed a solid mass with irregular margins and anechoic nodules in a postsurgical breast, but although fat necrosis was suggested, periodic mammographic follow-up of this probably benign lesion was performed. The last mammography (Fig. 1) showed again an increase in size of the density suspected of local recurrence. The magnetic resonance imaging (MRI) (Fig. 2) revealed postoperative scarring in the left breast and there were findings compatible with early tumor recurrence after conservative surgery, so surgical excision was performed. Histopathologically the tumor was fibromatosis of the breast and there was no evidence of malignancy (Fig. 3). Mammary fibromatosis is an uncommon benign lesion that clinically and radiologically may simulate breast cancer [1–5]. This unusual lesion has been presented in literature as a diagnostic challenge in a few cases series, describing its clinical, radiological and pathological features, but we did not find any report of fibromatosis of the breast after conservative cancer treatment simulating recurrent carcinoma. This lesion is included as a variant of spindle cell tumor of the breast, which can result in a wide spectrum of