Traumatic Neuromas After Mastectomy

Wang, Xin; Cao, Xunchen; Ning, Lu

doi:10.1111/j.1445-2197.2007.04194.x

Cited by 13 publications

(7 citation statements)

References 3 publications

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“…AlSharif et al [4] reported that the mean time between mastectomy and the detection of a neuroma was 10.3 years (range, 2 to 22 years), and Wang et al [6] reported that three of six neuromas were detected more than 5 years after mastectomy. However, the mean time to diagnosis of the traumatic neuromas after mastectomy in our study was 5.6 years (range, 1.9 to 11.1 years).…”

Section: Discussionmentioning

confidence: 99%

“…If a traumatic neuroma occurs in the breast or chest wall after oncologic surgery (breast-conserving surgery or mastectomy), it is difficult to clinically and radiologically differentiate from recurrence of the tumor, and a core needle biopsy or an excisional biopsy must be performed to obtain a pathologic diagnosis. To our knowledge, the imaging findings of traumatic neuroma in the breast or chest wall after surgery have only been described in 21 cases: 20 cases in six reports written in English [2,4,6,8-10], and one case report involving a Korean patient [5]. The majority of the articles were individual case reports.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonographic features of traumatic neuromas in breast cancer patients after mastectomy

Sung

Kim

2017

Ultrasonography

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PurposeThe purpose of this study was to evaluate the ultrasonographic (US) features of traumatic neuromas in breast cancer patients after mastectomy.MethodsThis study was performed with approval from our Institutional Review Board, and the requirement for informed consent was waived. Six traumatic neuromas in five patients were included in this study. The US findings of traumatic neuromas were evaluated retrospectively by two radiologists according to the Breast Imaging-Reporting and Data System (BI-RADS) lexicon. The final assessment was also recorded.ResultsOn US, all six lesions presented as a mass within the pectoralis muscle layer (mean size, 4.8 mm; range, 3.9 to 5.5 mm). Of the six masses, four had an oval shape with a circumscribed margin, and two had an irregular shape and an indistinct margin. They were all hypoechoic. Two lesions showed a non-parallel orientation. On color Doppler examinations, two lesions showed internal vascularity. Strain elastography was performed for four neuromas, resulting in scores of 1 (n=1), 4 (n=2), and 5 (n=1). The final assessment categories were BI-RADS 3 (n=2), 4A (n=2), and 4B (n=2).ConclusionOn US, an oval shape, circumscribed margin, parallel orientation, and hypoechogenicity were the most frequent features of traumatic neuromas in breast cancer patients after mastectomy. Neuromas may show increased vascularity on color Doppler imaging and present as a hard mass on elastography.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasonographic features of traumatic neuromas in breast cancer patients after mastectomy

Sung

Kim

2017

Ultrasonography

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“…On ultrasonography, TBN may appear as a homogenous well circumscribed hypoechoic mass with no internal vascular flow on color Doppler imaging (6,18,20,21). In some cases, however, TBN may appear as an irregularly shaped mass with indistinct margins and nonparallel orientation (10,23). A tail sign on ultrasonography has been reported in 50% of the cases reported by Al Sharif et al (6).…”

Section: Discussionmentioning

confidence: 99%

“…TBN should always be distinguished from recurrent breast cancer (21,23). Clinically, the location of TBN in the pectoral muscle layer may be helpful in the differential diagnosis, since a recurrent breast cancer is most commonly detected in the subcutaneous fat layer of the chest wall (10,20).…”

Section: Discussionmentioning

confidence: 99%

Traumatic neuroma as a rare cause of intractable neuropathic breast pain following cancer surgery: Management and review of the literature

Salemis¹

2018

IRDR

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Traumatic neuroma of the breast after cancer surgery is a very rare clinical entity with only a few cases having been reported to date. We herein present a very rare case of traumatic breast neuroma in a postmenopausal patient with a history of breast-conserving surgery, who presented with a four-month history of intractable neuropathic breast pain. Diagnostic evaluation and management are discussed along with a review of the literature. Traumatic breast neuromas are very rare benign lesions that have been reported mainly after mastectomy. Our literature review yielded only 35 cases of traumatic breast neuromas in 28 patients, reported so far. Although imaging features may be indicative of a benign lesion, surgical excision is necessary to obtain a definitive diagnosis and to rule out a recurrent breast cancer. Conservative treatment is feasible in properly selected cases with asymptomatic neuromas after an accurate tissue sampling. The case presented herein underlines the necessity to consider traumatic neuroma in the differential diagnosis in patients with a history of breast surgery presenting with refractory neuropathic breast pain. A high index of suspicion is required because the lesion may be too small and can be missed on imaging investigations.

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“…In US, most lesions comprised oval, well-circumscribed, parallel, and avascular nodules that were homogenously hypoechoic, [4–10] which were consistent with our report. However, 4 lesions exhibited indistinct margin and irregular shape, [3,10] 2 lesions in 1 patient demonstrated inner vascularity, [10] and one 0.2-cm lesion was unremarkable in a surgical scar after breast-conserving surgery. [11] The tail sign was described in 2 reports with an incidence of 33.3% to 50%.…”

Section: Discussionmentioning

confidence: 99%

Traumatic neuroma in mastectomy scar

Chen¹,

Zhang²,

Huang³

et al. 2019

Medicine

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Rationale: Traumatic neuroma is a reparative proliferative response of the nerve after trauma or surgery, which rarely occurs in the breast. However, it must be distinguished from tumor recurrence. Patient concerns: A 78-year-old woman underwent left-sided modified radical mastectomy for invasive carcinoma, 7 years before this case. Two painless nodules near the mastectomy scar were discovered in regular follow-up physical examination. A 62-year-old woman had received right-sided modified radical mastectomy for intraductal carcinoma, 4 years before this case. An asymptomatic nodule near the mastectomy scar was detected during follow-up ultrasound (US) examination. Diagnosis: The lesions in both patients were diagnosed as traumatic neuroma. Interventions: The first patient underwent excisional biopsy. The second patient underwent US guided core-needle aspiration, followed by conservative therapy. Outcomes: Neither patient complained of any discomfort, nor both exhibited normal physical and US findings during follow-up examinations. Lessons: Newly discovered nodules with the benign imaging features near the mastectomy site of a patient, especially with the tail sign, traumatic neuromas should be taken into consideration. Routine US examination is important for follow-up of breast cancer patients who have undergone mastectomy.

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Traumatic Neuromas After Mastectomy

Cited by 13 publications

References 3 publications

Ultrasonographic features of traumatic neuromas in breast cancer patients after mastectomy

Ultrasonographic features of traumatic neuromas in breast cancer patients after mastectomy

Traumatic neuroma as a rare cause of intractable neuropathic breast pain following cancer surgery: Management and review of the literature

Traumatic neuroma in mastectomy scar

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