Outcome and prognostic factors in breast sarcoma: a multicenter study from the rare cancer network.
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.
Bousquet
Guilhem
G
Oscar Lambret Anti-Cancer Center, 3 rue Frédéric Combemale, Lille, France.
Confavreux
Cyril
C
Magné
Nicolas
N
de Lara
Christine Tunon
CT
Poortmans
Philip
P
Senkus
Elzbieta
E
de Lafontan
Brigitte
B
Bolla
Michel
M
Largillier
Remy
R
Lagneau
Edouard
E
Kadish
Sidney
S
Lemanski
Claire
C
Ozsahin
Mahmut
M
Belkacémi
Yazid
Y
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