Breast metastases in children and adolescents with rhabdomyosarcoma: Experience of the Italian Soft Tissue Sarcoma Committee.
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.
D'Angelo
Paolo
P
Pediatric Hematology and Oncology Unit, G. Di Cristina Children's Hospital, Palermo, Italy. oncoematoped@ospedalecivicopa.org
Carli
Modesto
M
Ferrari
Andrea
A
Manzitti
Carla
C
Mura
Rossella
R
Miglionico
Lucia
L
Di Cataldo
Andrea
A
Grigoli
Antonella
A
Cecchetto
Giovanni
G
Bisogno
Gianni
G
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*