Dermatofibrosarcoma Protuberans Presenting as a Primary Breast Mass

Dermatofibrosarcoma protuberans (DFSP) is an atypical soft tissue malignancy that affects the dermis and subcutaneous tissue. The cause of DFSP is not clearly understood. This report highlights a rare case of DFSP of the left breast. We report a case of an 18-year-old female with past medical history of type 1 diabetes mellitus, who presented to the breast imaging clinic with a six-month history of left breast lump and associated skin discoloration. The patient had a dedicated left breast ultrasound which showed an indistinct, oval, hyperechoic mass in the superficial breast, measuring 1.4 x 1.0 x 2.5 cm with mild internal vascularity. An ultrasound-guided biopsy of this left breast mass was recommended and performed approximately three weeks later, demonstrating DFSP. The patient was then advised for consultation with Oncology, Surgical Oncology, and Radiation Oncology, to which surgical excision was the final recommendation. The patient had a wide local surgical excision procedure for her left breast mass with surgical pathology confirming negative margins shortly thereafter. This case highlights a great index of suspicion that should be taken when evaluating palpable breast masses with associated skin discoloration in young patients.