title: Breast metastases in children and adolescents with rhabdomyosarcoma: Experience of the Italian Soft Tissue Sarcoma Committee.
abstract: BACKGROUND
  Breast metastasis from rhabdomyosarcoma (RMS) is an uncommon event but may be problematic in treatment decision-making. Aim of the study was to evaluate clinical characteristics, treatment, and subsequent outcome, of patients with RMS metastasis in the breast, enrolled in four consecutive Associazione Italiana di Ematologia ed Oncologia Pediatrica (AIEOP) Soft Tissue Sarcoma Committee protocols during the last 20 years, in order to obtain information to establish a more adequate diagnostic and therapeutic approach.
  
  
  METHODS
  Data were derived from the AIEOP STSC database and reviewed for the purpose of this study.
  
  
  RESULTS
  From 1988 to 2008, among 189 patients with metastatic RMS, we identified 7 (3.7%) patients with RMS with breast involvement at diagnosis. All patients were females, aged 13-17 years with alveolar histology and multiple metastasis sites (2-5). The primary tumor was located in the extremities in 3/7 patients. In spite of intensive treatment no patient survived. The cause of treatment failure was distant relapse in six patients, including two on the mammary region. Treatment data analysis revealed that local measures to control breast lesions were used in only two patients.
  
  
  CONCLUSIONS
  Our data suggest that investigations of the mammary region should be part of the usual diagnostic workup in adolescent girls with alveolar RMS, especially if the primary tumor arises in the extremities. New and more effective strategies are needed to improve the outcome of these patients including aggressive local measures to control breast disease.
authors: Pediatric Hematology and Oncology Unit, G. Di Cristina Children's Hospital, Palermo, Italy. oncoematoped@ospedalecivicopa.org
authors: Paolo
authors: P
authors: D'Angelo
authors: Modesto
authors: M
authors: Carli
authors: Andrea
authors: A
authors: Ferrari
authors: Carla
authors: C
authors: Manzitti
authors: Rossella
authors: R
authors: Mura
authors: Lucia
authors: L
authors: Miglionico
authors: Andrea
authors: A
authors: Di Cataldo
authors: Antonella
authors: A
authors: Grigoli
authors: Giovanni
authors: G
authors: Cecchetto
authors: Gianni
authors: G
authors: Bisogno
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D005260:Female; D006801:Humans; D019042:Muscle Neoplasms / Q000473:pathology*; D018482:Muscle, Skeletal; D012208:Rhabdomyosarcoma / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*