Primary soft tissue sarcomas of the breast: local-regional control with post-operative radiotherapy

Johnstone, Peter A.S.; Pierce, Lori J.; Merino, María J.; Yang, James Chih‐Hsin; Epstein, A. H.; DeLaney, Thomas F.

doi:10.1016/0360-3016(93)90395-c

Cited by 71 publications

(47 citation statements)

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“…Reported series in the English literature had included all three entities as breast sarcomas, and include in their reports angiosarcomas, desmoid tumours, and lymphosarcomas (Botham et al, 1958;Berg et al, 1962;Oberman, 1965;Donegan, 1967;Fawcett, 1967;Kennedy and Biggart, 1967;Norris and Taylor, 1968;Rissanen and Holsti, 1968;Gogas et al, 1976;Barnes and Pietruszka, 1977;Ludgate et al, 1977;Khanna et al, 1981;Callery et al, 1985;Christensen et al, 1988;Stanley et al, 1988;Terrier et al, 1989;Pollard et al, 1990;Pitts et al, 1991;Ciatto et al, 1992;Luna Vega et al, 1992;Johnstone et al, 1993;Smola et al, 1993;Gutman et al, 1994;McGregor et al, 1994;Moore and Kinne, 1996;North et al, 1998;Barrow et al, 1999;McGowan et al, 2000). Therefore, reliable assessments of prognostic factors are difficult to make based on the published literature.…”

Section: Discussionmentioning

confidence: 99%

“…However, series in the literature have included many different entities under the rubric of sarcomas such as cystosarcoma phyllodes, lymphosarcoma and carcinosarcoma (Botham et al, 1958;Donegan, 1967;Fawcett, 1967;Kennedy and Biggart, 1967;Rissanen and Holsti, 1968;Gogas et al, 1976;Ludgate et al, 1977;Khanna et al, 1981;Christensen et al, 1988;Terrier et al, 1989;Pitts et al, 1991;Ciatto et al, 1992;Luna Vega et al, 1992;McGregor et al, 1994;Moore and Kinne, 1996;McGowan et al, 2000). For this review, we choose to categorise primary breast sarcomas in histogenic terms, similar to other soft-tissue sarcomas, thus including angiosarcomas, and excluding malignant cystosarcomas phyllodes, as reported by others (see Table 1) (Berg et al, 1962;Oberman, 1965;Norris and Taylor, 1968;Barnes and Pietruszka, 1977;Callery et al, 1985;Stanley et al, 1988;Pollard et al, 1990;Johnstone et al, 1993;Smola et al, 1993;Gutman et al, 1994;North et al, 1998;Barrow et al, 1999). …”

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Primary breast sarcoma: clinicopathologic series from the Mayo Clinic and review of the literature

et al. 2004

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Primary sarcomas of the breast are extremely rare, with less than 0.1% of all malignant tumours of the breast. Mayo Clinic Surgical Pathology database was searched for all breast sarcoma from 1910 to 2000. Pathology reports and slides were reviewed and tumour types were determined. Metaplastic carcinomas and phyllodes tumours were excluded. There were 25 women ranging in age 24 -81 years (mean 45 years). All but one patient presented with a palpable lump. Mastectomy was performed in 19 patients and lumpectomy in five patients. Histopathological diagnoses were fibrosarcoma (six), angiosarcoma (six), pleomorphic sarcoma (six), leiomyosarcoma (two), myxofibrosarcoma (three), hemangiopericytoma (one) and osteosarcoma (one). Tumour size ranged from 0.3 to 12 cm (mean 5.7). Low-grade lesions were observed in 10 cases and high-grade in 15. Overall, mean follow-up was 10.5 years. Local recurrence was observed in 11 patients and ranged from 2 to 36 months (mean 15 m), while distant metastasis was observed in 10 patients (40%) affecting lungs, bones, liver, spleen, and skin. Of the 25 patients, 12 have died of disease and six of other causes. Five-year overall (OS) and cause-specific survival (CSS) were 66 and 70%, respectively. OS and DFS at 5 years were 91% for tumours p5 cm and 50% for tumours 45 cm. Tumour size was significantly associated with OS (risk ratio ¼ 1.3 per 1 cm increase; 95% CI, 1.02 -1.7; P ¼ 0.036). There was no significant difference in OS or CSS between low-and high-grade lesions. In this series, tumour size was a more valuable prognostic factor than tumour grade. Primary sarcomas of the breast are rare, malignant tumours arising from the mesenchymal tissue of the mammary gland (Oberman, 1965;Barnes and Pietruszka, 1977;Callery et al, 1985), with an approximate incidence of 17 new cases per million women (Moore and Kinne, 1996). At the Mayo Clinic, 27 881 malignant breast tumours were seen between 1940 and 1999 (C Adem, personal unpublished data) and 18 breast sarcomas were diagnosed accounting for 0.0006% of breast malignancies.Breast sarcomas should be distinguished from metaplastic carcinomas (Adem et al, 2002). When facing a spindle cell neoplasm in an epithelial organ such as the breast one should be careful in rendering the diagnosis of sarcoma. In this setting, immunohistochemistry using the right antibodies is of major input. Berg et al defined stromal sarcomas of the breast in 1962 as a group of mesenchymal malignant tumours with fibrous, myxoid and adipose components, excluding malignant cystosarcoma phyllodes, lymphomas and angiosarcomas (Berg et al, 1962). However, series in the literature have included many different entities under the rubric of sarcomas such as cystosarcoma phyllodes, lymphosarcoma and carcinosarcoma (Botham et al, 1958;Donegan, 1967;Fawcett, 1967;Kennedy and Biggart, 1967;Rissanen and Holsti, 1968;Gogas et al, 1976;Ludgate et al, 1977;Khanna et al, 1981;Christensen et al, 1988;Terrier et al, 1989;Pitts et al, 1991;Ciatto et al, 1992;Luna Vega et al, 1992;McGregor et al,...

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Section: Discussionmentioning

confidence: 99%

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Primary breast sarcoma: clinicopathologic series from the Mayo Clinic and review of the literature

et al. 2004

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“…Adjuvant radiotherapy after surgery, according to Johnstone et al allows for better local control 19 , but without effect on overall survival as noted by Pandey et al 20 . In our group, 45% of patients were treated with adjuvant radiotherapythat is a higher ratio than reported in the literature, where cohorts were larger in overall size 21,22 .…”

Section: Discussionmentioning

confidence: 98%

Primary Angiosarcoma of the Breast—Series of 11 Consecutive Cases—A Single-Centre Experience

et al. 2018

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Angiosarcomas of the breast are rare parenchymal malignancies of the chest wall. Surgery is the main treatment modality with chemotherapy and radiotherapy used in case of recurrence. With generally unfavourable prognosis and lack of clear treatment guidelines due to its rarity and scarcity of available data, angiosarcoma of the breast is a challenging clinical situation for both oncologist and patient. We present here the results of a series of 11 consecutive primary angiosarcoma cases treated at our institute between 2000 and 2015.

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“…In one series of 14 out of 63 patients treated with radiation either alone or in combination with chemotherapy, there was no correlation to local control or survival (28). In two series, a benefit to the 5 and 10 year recurrence free survival, DFS and OS was seen following radiotherapy (29,32). While there has been suggestion that adjuvant radiotherapy may benefit selected patients, the majority of the data has been based on small retrospective studies that have failed to draw strong conclusions.…”

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confidence: 96%

Primary and Secondary Angiosarcoma of the Breast

2016

Contemporary Diagnostic Radiology

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Angiosarcoma is a rare soft tissue tumor of the breast. It occurs in both a primary form without a known precursor, and a secondary form that has been associated to a history of irradiated breast tissue. These forms differ in many ways including median age, precipitating factors, and presentation. Both forms have a malignant behavior and a poor prognosis. The endeavor of this paper is to review what is known about the presentation, diagnostic and therapeutic modalities to date.

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Primary soft tissue sarcomas of the breast: local-regional control with post-operative radiotherapy

Cited by 71 publications

References 15 publications

Primary breast sarcoma: clinicopathologic series from the Mayo Clinic and review of the literature

Primary breast sarcoma: clinicopathologic series from the Mayo Clinic and review of the literature

Primary Angiosarcoma of the Breast—Series of 11 Consecutive Cases—A Single-Centre Experience

Primary and Secondary Angiosarcoma of the Breast

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