title: Outcome and prognostic factors in breast sarcoma: a multicenter study from the rare cancer network.
abstract: OBJECTIVE
  Breast sarcoma (BS) is a rare tumour. While surgical resection is the primary treatment, the role of radiation therapy (RT) and chemotherapy remains unclear. This study aimed at defining prognostic factors and treatment strategies.
  
  
  METHODS
  Data from 103 patients treated between 1976 and 2002 were collected. The median age was 55 years (range: 13-86); the median histological tumour size was 4.45 cm (range: 0.8-22). There were 42 angiosarcomas. Surgery consisted of wide excision in 34 cases, and total mastectomy in 69 cases. A total dose of 50 Gy in 25 fractions was delivered in 50 patients. At the completion of treatment, 89 patients had no residual tumour.
  
  
  RESULTS
  After a median follow-up of 64 months, 56 patients developed recurrent disease: 38 presented a local relapse and 37 developed distant metastases. The 5-year disease-free survival (DFS) and overall survival (OS) were 44% (95% confidence interval [CI], 39-49%) and 55% (95% CI, 50-60%), respectively. In multivariate analysis, favourable prognostic factors for better local control were: no residual tumour after treatment, no cellular pleomorphism, and histology other than angiosarcoma. For DFS, the five favourable prognostic factors were non-menopausal status, no residual tumour after treatment, non-angiosarcoma histology, absence of tumour necrosis, and grade 1-2 histology.
  
  
  CONCLUSIONS
  While angiosarcoma has the worst prognosis, the outcome of the other types of sarcomas may be worsened by residual tumour after loco-regional treatment and high grade histology, a classical prognostic factor of the other soft tissue sarcomas. During surgical procedure axillary dissection is not mandatory.
authors.affiliation: Oscar Lambret Anti-Cancer Center, 3 rue Frédéric Combemale, Lille, France.
authors.forename: Guilhem
authors.initials: G
authors.lastname: Bousquet
authors.forename: Cyril
authors.initials: C
authors.lastname: Confavreux
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
authors.forename: Christine Tunon
authors.initials: CT
authors.lastname: de Lara
authors.forename: Philip
authors.initials: P
authors.lastname: Poortmans
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Senkus
authors.forename: Brigitte
authors.initials: B
authors.lastname: de Lafontan
authors.forename: Michel
authors.initials: M
authors.lastname: Bolla
authors.forename: Remy
authors.initials: R
authors.lastname: Largillier
authors.forename: Edouard
authors.initials: E
authors.lastname: Lagneau
authors.forename: Sidney
authors.initials: S
authors.lastname: Kadish
authors.forename: Claire
authors.initials: C
authors.lastname: Lemanski
authors.forename: Mahmut
authors.initials: M
authors.lastname: Ozsahin
authors.forename: Yazid
authors.initials: Y
authors.lastname: Belkacémi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006394:Hemangiosarcoma / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome