The London Sarcoma Service, University College London Hospitals, Euston Road, NW1 2PG, UK.
Research Department of Oncology, University College London (UCL) Cancer Institute, 72 Huntley Street, WC1E 6DD, London, UK; NHS Digital, National Cancer Registration and Analysis Service, 7 and 8 Wellington Place, Leeds, LS1 4AP, UK.
Eur J Cancer. 2022 Oct;174:48-56. doi: 10.1016/j.ejca.2022.06.036. Epub 2022 Aug 12.
Breast sarcomas (BS) are rare cancers originating from mesenchymal breast tissue with a paucity of national population level data detailing their incidence and outcomes.
We performed an analysis of data collected by National Cancer Registration and Analysis Service (NCRAS) for patients diagnosed with BS between 2013 and 2018. Chi-square test was used to compare groups. Overall survival (OS) was calculated by Kaplan-Meier. Specialist sarcoma centres (SSC) were defined as centres with a sarcoma multidisciplinary team (MDT).
There were 684 patients with BS (357 malignant phyllodes tumours [PTs], 238 vascular tumours, 93 other morphology) with a median age of 64 (range 14-96); 187 (27%) had received breast radiotherapy for a prior malignancy; 633 (92%) had resection of the tumour within 12 months of diagnosis. Five-year OS was 82%, 54% and 48% in patients with PT, vascular tumours and other sarcomas, respectively, and 55% for those with radiation-induced BS. Patients managed within SSC more frequently had a biopsy prior to surgery 83% versus 72%, p < 0.05) and were less likely to require multiple operations (26% versus 41%, p < 0.05). Tumour stage and grade data were not available.
This is the first population series evaluating incidence and outcomes for BS. Patients treated at non-specialist sarcoma centres (NSSCs) are less likely to have a biopsy prior to surgery and more likely to require multiple operations. Based on these observational data, we would recommend all BS are discussed at a sarcoma MDT meeting early in their pathway and surgery to be considered at SSC where possible.
乳腺肉瘤（BS）是一种罕见的癌症，起源于间叶组织的乳腺组织，关于其发病率和结果的全国性人群水平数据很少。
我们对 2013 年至 2018 年期间被诊断患有 BS 的患者的国家癌症登记和分析服务（NCRAS）收集的数据进行了分析。使用卡方检验比较组间差异。通过 Kaplan-Meier 计算总生存率（OS）。专科肉瘤中心（SSC）被定义为具有肉瘤多学科团队（MDT）的中心。
共有 684 例 BS 患者（357 例恶性叶状肿瘤[PT]、238 例血管肿瘤、93 例其他形态），中位年龄为 64 岁（范围 14-96 岁）；187 例（27%）因先前恶性肿瘤接受过乳房放疗；633 例（92%）在诊断后 12 个月内切除肿瘤。PT、血管肿瘤和其他肉瘤患者的 5 年 OS 分别为 82%、54%和 48%，放射性 BS 患者为 55%。在 SSC 接受治疗的患者在手术前更频繁地进行活检（83%比 72%，p<0.05），且不太可能需要多次手术（26%比 41%，p<0.05）。肿瘤分期和分级数据不可用。
这是第一项评估 BS 发病率和结果的人群系列研究。在非专科肉瘤中心（NSSC）接受治疗的患者在手术前进行活检的可能性较低，需要多次手术的可能性较高。基于这些观察数据，我们建议所有 BS 在其治疗路径早期在肉瘤 MDT 会议上进行讨论，并尽可能在 SSC 进行手术。
