Sarcoma of the breast: Implications for extent of therapy. The M. D. Anderson experience

H. Gutman, R. E. Pollock*, M. I. Ross, R. S. Benjamin, D. A. Johnston, N. A. Janjan, M. M. Romsdahl

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

109 Scopus citations


Background. Sarcoma of the breast is a rare clinical entity for which there are no prospective data about extent of surgery indicated or role of multimodality therapy. The purpose of this study was to examine one of the largest single institutional experiences to shed light on these clinical issues. Methods. This study retrospectively reviewed 60 cases of sarcoma of the breast (cystosarcoma phyllodes excluded). Results. For the entire series there was a median overall survival time (OS) of 67 months and a disease- free survival period (DFS) of 18 months. Tumors smaller than 5 cm were associated with a better DFS (p < 0.04) and OS (p < 0.009). Patients with tumors less than 5 cm in diameter did equally well whether treated by wide local excision or mastectomy. Angiosarcoma histologic characteristics were associated with longer OS than stromal sarcoma (p = 0.017), malignant fibrous histiocytoma (p = 0.075), or fibrosarcoma (p = 0.08). Axillary dissections did not recover any nodal metastasis; moreover, treatment in 75% of the patients with negative nodes subsequently failed. Regional lymph node metastases were always and only in the context of disseminated disease. Adjuvant chemotherapy and/or radiotherapy was associated with prolonged DFS (p = 0.015). There was a trend toward improved local control with adjuvant radiotherapy (p = 0.14). Conclusions. Lesions less than 5 cm should be treated by breast-preserving wide local excision, and adjuvant radiotherapy should be considered for selected subgroups. For tumors 5 cm or larger, a more aggressive approach seems appropriate; consideration should be given to neoadjuvant chemoradiation followed by margin-negative surgery (if possible). There is no demonstrable staging or therapeutic role for routine axillary dissection.

Original languageEnglish
Pages (from-to)505-509
Number of pages5
Issue number3
StatePublished - 1994
Externally publishedYes


Dive into the research topics of 'Sarcoma of the breast: Implications for extent of therapy. The M. D. Anderson experience'. Together they form a unique fingerprint.

Cite this