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Sarcomas of the breast The Rare Cancer Network (www.rarecancer.net) study on breast sarcoma is the largest retrospective review of breast sarcomas published in the literature. Data from 103 patients have been collected in a retrospective multicenter study. The patients’ characteristics are similar to those reported in other publications, according to sex-ratio, mean age at diagnosis, and tumour size. Sarcoma of the breast is mainly a feminine tumour, and male cases usually represent less than 5% of primary breast sarcomas. Mean age is between 47 and 52 years, and mean tumour size is comprised between 5.5 and 5.7 cm. In the literature, tumour size as well as histological grade, which are classical prognostic factors of common soft tissues sarcomas, were variably found to influence recurrence and survival of sarcomas of the breast. In this report, there were 42 angiosarcomas. Surgery consisted of wide excision in 34 cases, and total mastectomy in 69 cases. RT was delivered in 50 patients at a median dose of 50 Gy in 25 fractions. At the completion of treatment, 89 patients had no residual tumor. After a median follow-up of 64 months, 56 patients had recurrent disease, 38 presented a local relapse, and 37 developed metastases. The 5-year disease-free survival (DFS) and overall survival (OS) were 44% (+/-5) and 55% (+/-5), respectively. In multivariate analysis, favorable prognostic factors for local control were: no residual tumor after treatment, no cellular pleomorphism, and histology other than angiosarcoma. For DFS, the five favorable prognostic factors were non-menopausal status, no residual tumor after treatment, non-angiosarcoma histology, absence of tumour necrosis, and grade 1-2 histology. In conclusion, Angiosarcoma has a dramatical prognosis. The outcome of the other types of sarcomas may be worsened by residual tumor after loco-regional therapy and high grade histology, a classical prognosis factor of the other soft tissue sarcomas. In surgical procedure axillary dissection is not mandatory.
Bibliographic Reference:
Yazid Belkacémi Oscar Lambret Center, Lille, France; University of Lille II, Lille, France
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