Application of volume displacement technique in the operation of breast dermatofibrosarcoma protuberans: A case report

Abstract

Rationale: – Dermatofibrosarcoma protuberans (DFSP) of the breast is exceedingly rare. Surgical management requires achieving negative margins while preserving breast aesthetics, which presents a significant challenge. This case demonstrates the use of the volume displacement technique as a reconstructive approach to balance oncologic safety with cosmetic outcomes. Patient concerns: – A 41-year-old woman was referred for evaluation of a palpable mass in the left breast, identified during routine physical examination. She reported no pain or systemic symptoms. Diagnoses: – Imaging revealed a subcutaneous mass with mixed echogenicity and abundant vascularity. Core biopsy suggested a spindle cell tumor. Histopathology and immunohistochemistry confirmed the diagnosis of DFSP (CD34 positive, Vimentin positive, negative for other markers). Interventions: – The patient underwent wide local excision with negative margins under general anesthesia, followed by immediate reconstruction using the volume displacement technique to preserve breast contour. Outcomes: – Postoperative pathology confirmed complete tumor removal with negative margins. The patient recovered without complications, and no recurrence was observed during follow-up. Cosmetic results were satisfactory. Lessons: – DFSP of the breast is rare, and achieving oncologic safety without compromising aesthetics is challenging. The volume displacement technique offers a valuable reconstructive option, allowing wide excision while maintaining breast contour. This approach may serve as a useful strategy in similar cases, though further studies are needed to confirm its broader applicability and long-term outcomes.