Traumatic neuromas in breast cancer patients after mastectomy

Abstract

Objective

Traumatic neuromas are rare benign lesions occurring post-mastectomy, which are usually suspected as tumour recurrences before excision biopsy. We report six cases presenting with palpable nodules postmastectomy, to emphasize the differential diagnosis of traumatic neuroma from recurrent cancer.

Methods

Six cases were reviewed. The age of patients ranged from 33 to 61 years. Nodular masses were found close to the mastectomy scar during follow-up over a period of 2.8 to 8 years.

Results

In one patient three nodular masses were detected. Five patients had received chemotherapy, three of which had also received radiotherapy. Ultrasound examinations showed a well-circumscribed, homogeneous, hypo-echoic subcutaneous nodular lesion in four cases, and a poorly defined hypo-echoic nodule with good conduction in two cases. No obvious distant metastases had been identified. Each patient underwent surgical excisional biopsy. All of nodules had a diameter less than 1 cm. Histopathological examination showed proliferation of nerve fibre bundles, which were disordered, oriented and well circumscribed in fibro-adipose tissue.

Conclusion

It was concluded that all of the lesions were traumatic neuromas, independent from the initial tumor. Traumatic neuromas occurring in mastectomy scars are difficult to distinguish from a tumor recurrence. Although radiological evaluation of the mass with ultrasound is of value, the diagnosis can only be confirmed following a histopathological evaluation.