Primary sarcoma of the breast.
OBJECTIVE
Primary sarcoma occurring in breast is rare and comprises 0.5-1% of all breast neoplasm. Majority of the series include both stromal and cystosarcoma phyllodes, only a few hundred cases of sarcomas other then cystosarcoma are reported.


METHODS
We carried out a retrospective analysis of 19 patients with primary sarcoma of the breast treated between 1982 and 2002.


RESULTS
Mean age of the patients was 38.6 years (12-70 years). Gradually progressive swelling was the commonest presenting feature. There were eight cases of angiosarcoma, four cases of spindle cell sarcoma, two each of pleomorphic sarcoma and stromal sarcoma, and one each of malignant fibrous histiocytoma, embryonal rhabdomyosarcoma, and sarcoma (NOS). Eight of these were high-grade (42%). Eight patients underwent either radical or modified mastectomy, three underwent wide excisions, and one underwent quadrantectomy. Ten (52.6%) patients received postoperative adjuvant radiation. Two patients received chemotherapy. After a mean follow-up time of 34.5 months (median 25 months), eight patients failed. Failure was local in five, opposite breast in one, and both local and distant in two. The disease free survival at 3-year was 39%. In univariate analysis only the margin of first surgery was found to be a significant predictor of survival (P = 0.05).


CONCLUSIONS
Primary sarcomas of the breast are aggressive tumors. Surgical treatment should consist of at least simple mastectomy. All attempts should be made to achieve a negative margin as this appears to be the only factor influencing survival in these patients.
Pandey
Manoj
M
Division of Surgical Oncology, Regional Cancer Centre, Medical College, Trivandrum, Kerala, India. manojpandey@rcctvm.org
Mathew
Aleyamma
A
Abraham
Elizabeth K
EK
Rajan
Balakrishnan
B
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006394:Hemangiosarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D018219:Histiocytoma, Benign Fibrous / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D012509:Sarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D016019:Survival Analysis