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The most common location of the leiomyoma is uterus, small bowel and the esophagus, however they can occur in any organ. Intraparenchimal leiomyomas of the breast are very rare and only 30 cases were reported in the literature. These histologically benign tumors, may mimic malignancies and therefore may present a diagnostic challenge. Here, we present two new cases. The first case was a 50-year-old woman presented with a 4 cm firm mass in her right breast with discrete localized skin thickening/retraction. The second case was a 35-year-old woman presented with a painless palpable lump in the lower outer quadrant of her right breast. Physical examination, mammography and ultrasound as well as surgical excision were performed in both cases. According to histologic examination and immunohistochemical analysis, a diagnosis of smooth muscle tumor of the breast was made. These tumors clinically and radiologically mimic other breast lesions. Neither imaging studies nor palpation allow distinction between benign and malignant tumors.

Background We present a surgical technique and the preliminary results of breast cancer excision after insertion of a specially constructed marking needle into the tumor, controlled by intraoperative ultrasound. Resection margins were projected in six directions by ultrasound measurements, determined in relation to the needle, and resection was done in accordance with those measurements. The main objective was to obtain resection margins similar (equal) to those projected by intraoperative ultrasound (10 mm). Methods Detailed description of the technique is given. Thirty-two female patients undergoing breast-conserving surgery, up to 30 mm in diameter, for palpable and non-palpable invasive breast cancer, were operated on using this technique. Its feasibility was tested by analyzing the success (rate) of needle placement in the tumor, the measurements executed, and the performance of the excision. Results All stages of the technique were successfully performed to completion on all 32 patients. The procedure of needle placement and ultrasound measurement of distances took 11 min on average (between 6 and 20 min). The average distance of the tumor margin from the resection margin was 12.9 mm (2 to 30 mm, 95% confidence interval [11.9, 14.06]). There was one patient with a positive resection margin (3%). Conclusions The technique of excising palpable and non-palpable breast cancer by intraoperative ultrasound and an especially constructed marking needle is feasible and comfortable to perform. Preliminary results imply that resection volume can be rationalized, with the same or better oncological safety.