An analysis of 78 breast sarcoma patients without distant metastases at presentation

摘要: Abstract Purpose: A retrospective review of a single cancer center experience was undertaken to identify clinical or treatment prognostic factors for these unusual tumors, allow recommendation regarding management. Methods and Materials: The charts 76 women 2 men with breast sarcoma without distant metastases at presentation registered from 1958 1990 were reviewed. Pathology centrally reviewed in 54 cases. Histology, tumor size, grade, nodal status, age, menopausal history benign disease, extent surgery, resection margins, radiation dose each examined as potential by univariate analysis. To an analysis dose, total normalized daily fraction size Gy. Results: median age diagnosis 50.5 years (13–82 years). pathologic found be malignant cystosarcoma phyllodes 32 patients, the remainder being stromal (14), angiosarcoma (8), fibrosarcoma (7), carcinosarcoma (5), liposarcoma (4), other (8). Eighteen patients had grade I II 43 III IV, 18 not evaluable. 5- 10-year actuarial rates all 78 57% 48% cause-specific survival (CSS), 47% 42% relapse-free (RFR), respectively. local rate (LRFR) 75% both 5 10 years. 5-year CSS tumors 84% versus 55% IV ( p = 0.01). Conservative surgery mastectomy did lead statistically significant different outcomes CSS, RFR, LRFR. comparison positive negative margins showed LRFR 33% 80% 0.009). Pairwise comparisons 91% > 48 Gy either 50% ≤ no -values 0.03 0.06, Conclusion: authors propose that if surgical can achieved, should managed conservative postoperative irradiation microscopic tumoricidal (50 Gy) whole beast, least 60 bed. decision treat preceded preoperative multidisciplinary assessment. It is also recommended axillary lymph node dissection indicated, possible exception carcinosarcoma.