Breast sarcoma. A case report and review of literature.
BACKGROUND
Breast sarcomas are rare with an annual incidence of 4.6 cases/1,000,000 women. They can appear as primary forms or secondary to radiation therapy or chronic lymphedema.


METHODS
A 41 year old woman attended our hospital after having noticed an increase in the size of her fibroadenoma. The examination revealed a 7cm retroareolar nodule. Breast sonography described a hypoechoic bilobulated lesion and MRI showed a large size polinodular image, suggesting a Phyllodes tumor. A core needle biopsy was performed with a histological result of low-grade fusiform cells sarcoma on Phyllodes tumor so we proceeded to surgical treatment with a mastectomy. After two years and a half she noticed a tough nodule over the mastectomy scar, which was resected with a histological result of fusiform cells sarcoma. Considering the diagnosis of recurrence of the disease, surgery was undertaken.


CONCLUSIONS
Breast sarcoma is a rare but aggressive entity. Core biopsy is the procedure of choice for the diagnosis. Lymphatic spread is uncommon so nodal status in breast sarcoma is less informative. Staging study differs from other breast tumors and chest computed tomography is helpful since lungs are the predominant metastatic sites. The use of radiotherapy or chemotherapy is controversial and will depend on the risk of tumor recurrence.


CONCLUSIONS
Surgery represents the only potentially curative therapy for breast sarcoma. Tumor size and adequate resection margin are the most important prognostic factors. Approximately 80% of recurrences appear in the first two years.
Hospital Universitario Quirón Dexeus, Department of Gynaecology, Obstetrics and Reproductive Medicine, Salud de la Mujer Dexeus, Gran Via Carles III, 71-75, 08028 Barcelona, Spain. Electronic address: nurlia@dexeus.com.
Nuria
N
Li
Hospital Universitario Quirón Dexeus, Department of Gynaecology, Obstetrics and Reproductive Medicine, Salud de la Mujer Dexeus, Gran Via Carles III, 71-75, 08028 Barcelona, Spain. Electronic address: maicus@dexeus.com.
Maria Teresa
MT
Cusidó
Hospital Universitario Quirón Dexeus, Department of Gynaecology, Obstetrics and Reproductive Medicine, Salud de la Mujer Dexeus, Gran Via Carles III, 71-75, 08028 Barcelona, Spain. Electronic address: beanav@dexeus.com.
Beatriz
B
Navarro
Hospital Universitario Quirón Dexeus, Department of Gynaecology, Obstetrics and Reproductive Medicine, Salud de la Mujer Dexeus, Gran Via Carles III, 71-75, 08028 Barcelona, Spain. Electronic address: fratre@dexeus.com.
Francesc
F
Tresserra
Hospital Universitario Quirón Dexeus, Department of Gynaecology, Obstetrics and Reproductive Medicine, Salud de la Mujer Dexeus, Gran Via Carles III, 71-75, 08028 Barcelona, Spain. Electronic address: sonbau@dexeus.com.
Sonia
S
Baulies
Hospital Universitario Quirón Dexeus, Department of Gynaecology, Obstetrics and Reproductive Medicine, Salud de la Mujer Dexeus, Gran Via Carles III, 71-75, 08028 Barcelona, Spain. Electronic address: carara@dexeus.com.
Carmen
C
Ara
Hospital Universitario Quirón Dexeus, Department of Gynaecology, Obstetrics and Reproductive Medicine, Salud de la Mujer Dexeus, Gran Via Carles III, 71-75, 08028 Barcelona, Spain. Electronic address: raffab@dexeus.com.
Rafael
R
Fabregas
Breast cancer; Breast sarcoma; Case report; Chronic lymphedema; Mastectomy; Radiation therapy