Sarcoma of the breast: outcome and reconstructive options

Clin Breast Cancer. 2012 Dec;12(6):438-44. doi: 10.1016/j.clbc.2012.09.008. Epub 2012 Oct 11.


Introduction: Surgery is the mainstay of treatment for all breast sarcomas. The role of adjuvant chemotherapy and radiation therapy has not been clearly defined. The aim of this single-center retrospective study was to analyze prognostic factors, outcome, and recent advances.

Materials and methods: Data from 203 patients with all breast sarcomas treated in a single center were collected from 1996 to 2010. Phyllodes tumors and metastatic disease at presentation were excluded from the population. Thirty-six women and 1 man were included in the analysis. Local recurrence, metastatic disease, survival, and reconstructive outcome were evaluated.

Results: Thirty-four patients out of 37 (91.9%) had an angiosarcoma and 3 had a stromal sarcoma (8.1%). Twenty-one patients (56.8%) had previously undergone breast radiation therapy for breast carcinoma or lymphoma. Twenty-six patients (70.3%) underwent mastectomy, 14 of whom (53.8%) with breast reconstruction. Thirty-six patients (97.3%) had free margins, 1 (2.7%) had a microscopically focally involved margin after surgery. Five patients received adjuvant chemotherapy and 6 received adjuvant radiation therapy. Median follow-up was 58 months (range, 4-146 months). Twelve sarcoma-related deaths were observed with a 5-year cumulative incidence of 43.4%. Twenty-four sarcoma-related events were observed with a 5-year cumulative incidence of 70.8%. The same figure was 49.7% in patients affected by primary sarcoma and 85.7% in patients with secondary sarcoma (P = .06).

Conclusion: Secondary sarcomas were associated with a higher risk of events. Patients undergoing breast conservative surgery or reconstruction after mastectomy did not show a worse prognosis compared with patients undergoing mastectomy.

Publication types

  • Evaluation Study

MeSH terms

  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / mortality
  • Breast Neoplasms / rehabilitation
  • Breast Neoplasms / surgery*
  • Breast Neoplasms, Male / diagnosis
  • Breast Neoplasms, Male / mortality
  • Breast Neoplasms, Male / rehabilitation
  • Breast Neoplasms, Male / surgery*
  • Choice Behavior
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mammaplasty / methods*
  • Mastectomy, Segmental / methods
  • Mastectomy, Segmental / rehabilitation
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / mortality
  • Prognosis
  • Retrospective Studies
  • Sarcoma / diagnosis
  • Sarcoma / mortality
  • Sarcoma / surgery*
  • Survival Analysis
  • Treatment Outcome