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Primary soft tissue sarcoma of the breast

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Opinion statement

Primary soft tissue sarcoma (STS) of the breast is a rare and heterogeneous disease. The rarity of this tumor limits most studies to small retrospective case reviews and case reports. The optimal treatment of primary STS of the breast can best be determined through multidisciplinary discussions prior to the initiation of therapy. Whether chemotherapy is indicated is primarily determined by tumor size. There is evidence that tumors larger than 5 cm are associated with an elevated risk of systemic failure and a poor prognosis [1-3]. Negative surgical margins are more important for local recurrence and overall survival than is the extent of surgical resection [1]. Thus, neoadjuvant chemotherapy should be considered in order to shrink the tumor and help obtain negative surgical margins. After surgical resection, patients with chemosensitive tumors should undergo additional adjuvant chemotherapy to treat micrometastatic disease. Patients with tumors less than 5 cm that are easily resectable should undergo complete resection to the extent required to provide negative surgical margins. Radiation therapy should be used to improve local control in cases in which the tumor is larger than 5 cm and in cases with positive surgical margins [4-6]. The appropriate treatment of primary STS of the breast requires a multidisciplinary approach necessitating experienced surgeons, pathologists, radiotherapists, and medical oncologists.

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References and Recommended Reading

  1. Gutman H, Pollock RE, Ross MI, et al.: Sarcoma of the breast: implications for extent of therapy. The M. D. Anderson experience. Surgery 1994, 116:505–509.

    PubMed  CAS  Google Scholar 

  2. Ciatto S, Bonardi R, Cataliotti L, et al.: Sarcomas of the breast: a multicenter series of 70 cases. Neoplasma 1992, 39:375–379.

    PubMed  CAS  Google Scholar 

  3. Ludgate CM, Anderson TJ, Langlands AO: Sarcoma of the female breast—report of a series of 30 cases. Clin Oncol 1977, 3:97–105.

    PubMed  CAS  Google Scholar 

  4. Barrow BJ, Janjan NA, Gutman H, et al.: Role of radiotherapy in sarcoma of the breast—a retrospective review of the M.D. Anderson experience. Radiother Oncol 1999, 52:173–178.

    Article  PubMed  CAS  Google Scholar 

  5. Antman KH, Corson J, Greenberger J, et al.: Multimodality therapy in the management of angiosarcoma of the breast. Cancer 1982, 50:2000–2003.

    Article  PubMed  CAS  Google Scholar 

  6. Johnstone PA, Pierce LJ, Merino MJ, et al.: Primary soft tissue sarcomas of the breast: local-regional control with post-operative radiotherapy. Int J Radiat Oncol Biol Phys 1993, 27:671–675.

    PubMed  CAS  Google Scholar 

  7. Russell WO, Cohen J, Enzinger F, et al.: A clinical and pathological staging system for soft tissue sarcomas. Cancer 1977, 40:1562–1570.

    Article  PubMed  CAS  Google Scholar 

  8. Oberman HA: Sarcomas of the breast. Cancer 1965, 18:1233–1243.

    Article  PubMed  CAS  Google Scholar 

  9. May DS, Stroup NE: The incidence of sarcomas of the breast among women in the United States, 1973-1986 [letter]. Plast Reconstr Surg 1991, 87:193–194.

    Article  PubMed  CAS  Google Scholar 

  10. Moore MP, Kinne DW: Breast sarcoma. Surg Clin North Am 1996, 76:383–392.

    Article  PubMed  CAS  Google Scholar 

  11. Ward RM, Evans HL: Cystosarcoma phyllodes. A clinicopathologic study of 26 cases. Cancer 1986, 58:2282–2289.

    Article  PubMed  CAS  Google Scholar 

  12. Berg J, Crosse JD, Fracchia A, et al.: A unified approach to connective tissue sarcomas other than cystosarcoma phyllodes. Cancer 1962, 15:418–424.

    Article  PubMed  CAS  Google Scholar 

  13. Callery CD, Rosen PP, Kinne DW: Sarcoma of the breast. A study of 32 patients with reappraisal of classification and therapy. Ann Surg 1985, 201:527–532.

    Article  PubMed  CAS  Google Scholar 

  14. Donegan WL: Sarcoma of the breast. Major Probl Clin Surg 1979, 5:504–542.

    PubMed  CAS  Google Scholar 

  15. Fawcett FJ: Sarcoma of breast. Br J Cancer 1967, 21:285–294.

    PubMed  CAS  Google Scholar 

  16. Gogas JG, Kotsianos G, Gogas KG: Sarcoma of the breast. Am Surg 1976, 42:812–816.

    PubMed  CAS  Google Scholar 

  17. Kennedy T, Biggart JD: Sarcoma of the breast. Br J Cancer 1967, 21:635–644.

    PubMed  CAS  Google Scholar 

  18. Kolarsick AJ: Primary sarcoma of the breast. J Med Soc N J 1972, 69:243–246.

    PubMed  CAS  Google Scholar 

  19. Prasad SB, Sinha MR: Stromal sarcoma of the breast. J Indian Med Assoc 1983, 81:89–91.

    PubMed  CAS  Google Scholar 

  20. Rissanen PM, Holsti P: A retrospective study of sarcoma of the breast and the results of treatment. Oncology 1968, 22:258–268.

    Article  PubMed  CAS  Google Scholar 

  21. Taghian A, de Vathaire F, Terrier P, et al.: Long-term risk of sarcoma following radiation treatment for breast cancer. Int J Radiat Oncol Biol Phys 1991, 21:361–367.

    PubMed  CAS  Google Scholar 

  22. Karlsson P, Holmberg E, Samuelsson A, et al.: Soft tissue sarcoma after treatment for breast cancer—a Swedish population-based study. Eur J Cancer 1998, 34:2068–2075.

    Article  PubMed  CAS  Google Scholar 

  23. Marchal C, Weber B, de Lafontan B, et al.: Nine breast angiosarcomas after conservative treatment for breast carcinoma: a survey from French comprehensive Cancer Centers. Int J Radiat Oncol Biol Phys 1999, 44:113–119.

    Article  PubMed  CAS  Google Scholar 

  24. McDivitt R, Urban J, Farrow J: Cystosarcoma phyllodes. Johns Hopkins Med J 1966, 120:33.

    Google Scholar 

  25. Engel A, Lamm SH, Lai SH: Human breast sarcoma and human breast implantation: a time trend analysis based on SEER data (1973-1990). J Clin Epidemiol 1995, 48:539–544.

    Article  PubMed  CAS  Google Scholar 

  26. McDivitt R, Stewart F, Berg J: Tumors of the breast. In Atlas of Tumor Pathology. Washington: Armed Forces Institute of Pathology; 1968.

    Google Scholar 

  27. Jones MW, Norris HJ, Wargotz ES, et al.: Fibrosarcomamalignant fibrous histiocytoma of the breast. A clinicopathological study of 32 cases. Am J Surg Pathol 1992, 16:667–674.

    Article  PubMed  CAS  Google Scholar 

  28. Barnes L, Pietruszka M: Sarcomas of the breast: a clinicopathologic analysis of ten cases. Cancer 1977, 40:1577–1585.

    Article  PubMed  CAS  Google Scholar 

  29. Christensen L, Schiodt T, Blichert-Toft M, et al.:Sarcomas of the breast: a clinicopathological study of 67 patients with long term follow-up. Eur J Surg Oncol 1988, 14:241–247.

    PubMed  CAS  Google Scholar 

  30. McGowan TS, Cummings BJ, O’Sullivan B, et al.:An analysis of 78 breast sarcoma patients without distant metastases at presentation. Int J Radiat Oncol Biol Phys 2000, 46:383–390.

    Article  PubMed  CAS  Google Scholar 

  31. Pollard SG, Marks PV, Temple LN, et al.: Breast sarcoma. A clinicopathologic review of 25 cases. Cancer 1990, 66:941–944.

    Article  PubMed  CAS  Google Scholar 

  32. Silva Neto JBD: Results of 22 cases of breast sarcoma over five years after surgery. Tumori 1970, 56:39–46.

    Google Scholar 

  33. Terrier P, Terrier-Lacombe MJ, Mouriesse H, et al.:Primary breast sarcoma: a review of 33 cases with immunohistochemistry and prognostic factors. Breast Cancer Res Treat 1989, 13:39–48.

    Article  PubMed  CAS  Google Scholar 

  34. Yoshida Y: Reticulum cell sarcoma of the breast. Case report and a review of the Japanese literature. Cancer 1970, 26:94–99.

    Article  PubMed  CAS  Google Scholar 

  35. McGregor GI, Knowling MA, Este FA: Sarcoma and Cystosarcoma phyllodes tumors of the breast--a retrospective review of 58 cases. Am J Surg 1994, 167:477–480.

    Article  PubMed  CAS  Google Scholar 

  36. Elson BC, Ikeda DM, Andersson I, et al.: Fibrosarcoma of the breast: mammographic findings in five cases. AJR Am J Roentgenol 1992, 158:993–995.

    PubMed  CAS  Google Scholar 

  37. Liberman L, Bonaccio E, Hamele-Bena D, et al.:Benign and malignant phyllodes tumors: mammographic and sonographic findings. Radiology 1996, 198:121–124.

    PubMed  CAS  Google Scholar 

  38. Bakheet SM, Powe J, Ezzat A, et al.: F-18 FDG wholebody positron emission tomography scan in primary breast sarcoma. Clin Nucl Med 1998, 23:604–608.

    Article  PubMed  CAS  Google Scholar 

  39. Costa J, Wesley RA, Glatstein E, et al.: The grading of soft tissue sarcomas. Results of a clinicohistopathologic correlation in a series of 163 cases. Cancer 1984, 53:530–541.

    Article  PubMed  CAS  Google Scholar 

  40. Beahrs O, Henson D, Hutter R, et al.: Manual for Staging of Cancer, edn 4. Philadelphia: Lippincott; 1992.

    Google Scholar 

  41. Chen KT, Kirkegaard DD, Bocian JJ: Angiosarcoma of the breast. Cancer 1980, 46:368–371.

    Article  PubMed  CAS  Google Scholar 

  42. Donnell RM, Rosen PP, Lieberman PH, et al.: Angiosarcoma and other vascular tumors of the breast. Am J Surg Pathol 1981, 5:629–642.

    Article  PubMed  CAS  Google Scholar 

  43. Hines JR, Murad TM, Beal JM: Prognostic indicators in cystosarcoma phylloides. Am J Surg 1987, 153:276–280.

    Article  PubMed  CAS  Google Scholar 

  44. Murad TM, Hines JR, Beal J, et al.: Histopathological and clinical correlations of cystosarcoma phyllodes. Arch Pathol Lab Med 1988, 112:752–756.

    PubMed  CAS  Google Scholar 

  45. Hart WR, Bauer RC, Oberman HA: Cystosarcoma phyllodes. A clinicopathologic study of twenty-six hypercellular periductal stromal tumors of the breast. Am J Clin Pathol 1978, 70:211–216.

    PubMed  CAS  Google Scholar 

  46. Hajdu SI, Espinosa MH, Robbins GF: Recurrent cystosarcoma phyllodes: a clinicopathologic study of 32 cases. Cancer 1976, 38:1402–1406.

    Article  PubMed  CAS  Google Scholar 

  47. Kessinger A, Foley JF, Lemon HM, et al.: Metastatic cystosarcoma phyllodes: a case report and review of the literature. J Surg Oncol 1972, 4:131–147.

    Article  PubMed  CAS  Google Scholar 

  48. Patel S, Vadhan-Raj S, Papadopoulos N, et al.: Highdose Ifosfamide in bone and soft-tissue sarcomas— results of phase II and pilot studies—dose response and schedule dependence. J Clin Oncol 1997, 15:2378–2384. These data from phase II and pilot studies found a remarkable 45% response rate in STS patients previously treated with doxorubicin-based chemotherapy.

    PubMed  CAS  Google Scholar 

  49. PatelS, Vadhan-Raj S, Burgess M, et al.: Results of two consecutive trials of dose-intensive chemotherapy with doxorubicin and ifosfamide in patients with sarcomas. Am J Clin Oncol 1998, 21:317–321. These two trials showed that overall response rates of 64% are possible with dose-intense combination chemotherapy. Although the response rates are excellent, the toxicity is not trivial; this regimen is best administered at a major referral center that has experience in the management of STS.

    Article  PubMed  CAS  Google Scholar 

  50. Patel S, Jenkins J, Papadopoulos N, et al.: Preliminary results of a two-arm phase 2 trial of gemcitabine in patients with gastrointestinal leiomyosarcomas and other soft-tissue sarcomas. Proc Am Soc Clin Oncol 1999, 18:541A.

    Google Scholar 

  51. Demetri GD, Fletcher CD, Mueller E, et al.: Induction of solid tumor differentiation by the peroxisome proliferator-activated receptor-gamma ligand troglitazone in patients with liposarcoma. Proc Natl Acad Sci USA 1999, 96:3951–3956.

    Article  PubMed  CAS  Google Scholar 

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Trent, J.C., Benjamin, R.S. & Valero, V. Primary soft tissue sarcoma of the breast. Curr. Treat. Options in Oncol. 2, 169–176 (2001). https://doi.org/10.1007/s11864-001-0059-8

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