Matsumoto Renato Augusto Eidy Kiota, Hsieh Su Jin Kim, Chala Luciano Fernandes, de Mello Giselle Guedes Netto, de Barros Nestor
Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
Grupo Fleury, São Paulo, SP, Brazil.
Radiol Bras. 2018 Nov-Dec;51(6):401-406. doi: 10.1590/0100-3984.2016.0141.
Sarcomas of the breast belong to a heterogeneous group of breast tumors of mesenchymal origin, without epithelial components. These tumors can be primary or secondary (after previous treatment for breast cancer), are rare, present aggressive behavior, and have a poor prognosis. They occur mainly in women between 45 and 50 years of age, with the exception of angiosarcomas, which can occur in younger patients. Clinically, breast sarcomas manifest as palpable, mobile, rapidly growing masses, without skin thickening, axillary lymphadenopathy, or nipple discharge. Although the imaging findings are non specific, they can be suggestive of sarcoma. For instance, a solitary mass showing rapid growth, with circumscribed or indistinct margins and, a complex (solid-cystic) or heterogeneous echotexture, without axillary lymph node involvement, can raise the suspicion of sarcoma. The treatment is not well established, because of the rarity and heterogeneity of this type of neoplasm. The principles of treatment for sarcoma of the breast have been addressed only in small cohort studies. In most cases, the treatment of choice is surgery without axillary lymphadenectomy.
乳腺肉瘤属于一组异质性的间叶源性乳腺肿瘤，不含上皮成分。这些肿瘤可以是原发性的，也可以是继发性的（在先前接受乳腺癌治疗之后），较为罕见，具有侵袭性，预后较差。它们主要发生在45至50岁的女性中，血管肉瘤除外，后者可发生于较年轻的患者。临床上，乳腺肉瘤表现为可触及的、活动的、生长迅速的肿块，无皮肤增厚、腋窝淋巴结肿大或乳头溢液。尽管影像学表现不具特异性，但可能提示肉瘤。例如，一个孤立性肿块生长迅速，边界清晰或不清晰，具有复杂（实性-囊性）或不均匀的回声结构，且无腋窝淋巴结受累，可能会引发对肉瘤的怀疑。由于这类肿瘤的罕见性和异质性，其治疗方法尚未明确确立。乳腺肉瘤的治疗原则仅在小型队列研究中有所探讨。在大多数情况下，首选的治疗方法是手术，不进行腋窝淋巴结清扫。
