Primary Breast Sarcomas: Prognostic Factors

Prognostic Factors in Primary Breast Sarcomas: A Series of Patients With Long-Term Follow-Up

L. Zelek, A. Llombart-Cussac, P. Terrier, X. Pivot, J.M. Guinebretiere, C. Le Pechoux, T. Tursz, F. Rochard, M. Spielmann, A. Le Cesne

From the Departments of Medicine, Pathology, Radiotherapy, and Surgery, Institut Gustave-Roussy, Villejuif, France.

Address reprint requests to Laurent Zelek, MD, Department of Oncology, CHU Henri Mondor, Assistance Publique, Hôpitaux de Paris, 51 Avenue Delattre de Tassigny, 94010 Créteil, Cedex, France; email: laurent.zelek@hmn.ap-hop-paris.fr.

Purpose: To describe the pathologic characteristics and prognostic factors of primary breast sarcomas (PBSs).

Patients and Methods: We reviewed the clinical records and pathologic slides of 83 women with PBS treated in our institution between 1954 and 1991, with a median follow-up of 7.8 years. The majority of patients had undergone surgical treatment.

Results: The main histologic type was malignant fibrohistiocytoma (n = 57). For the whole population, the 10-year overall survival (OS) and disease-free survival (DFS) rates were 62% and 50%, respectively.

For Fédération Nationale des Centres de Lutte Contre le Cancer grade 1, 2, and 3 tumors, the 10-year OS and DFS rates were 82% and 61%, 62% and 51%, and 36% and 25%, respectively (P = .00007 and .004, respectively).

For tumors measuring less than 5 cm, 5 to 10 cm, and more than 10 cm, the 10-year OS and DFS rates were 76% and 66%, 68% and 55%, and 28% and 15%, respectively (P = .002 and .009, respectively). In the multivariate analysis, the tumor size and histologic grade were correlated with the 10-year DFS rate (P = .04 and .01, respectively), but only the histologic grade was correlated with OS (P = .01).

Angiosarcoma was the only histologic type significantly associated with a poorer outcome in the multivariate analysis.

Conclusion: PBSs have the same clinical history and prognostic factors as sarcomas arising at other sites. Therefore, it is legitimate to use a similar treatment strategy for PBS as for other sarcomas.

Presented, in part, at the Twenty-First Annual Breast Cancer Symposium, San Antonio, TX, December, 3–6, 1997.

Journal of Clinical Oncology, Vol 21, Issue 13 (July), 2003: 2583-2588

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