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Incidence and Outcome of Breast Sarcomas in England (2013–2018): An analysis from the National Cancer Registration and Analysis Service

  • Ahmed M
    Correspondence
    Corresponding author: The London Sarcoma Service, University College London Hospitals, Euston Road, NW1 2PG
    Affiliations
    The London Sarcoma Service, University College London Hospitals, Euston Road, NW1 2PG, UK
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  • Collins S
    Affiliations
    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
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  • Franks J
    Affiliations
    Breast Service, University College London Hospitals, Euston Road, NW1 2PG, UK
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  • Lobo C
    Affiliations
    Breast Service, University College London Hospitals, Euston Road, NW1 2PG, UK
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  • Bacon A
    Affiliations
    NHS Digital, National Cancer Registration and Analysis Service, 7 and 8 Wellington Place, Leeds, LS1 4AP, UK
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  • Paley L
    Affiliations
    NHS Digital, National Cancer Registration and Analysis Service, 7 and 8 Wellington Place, Leeds, LS1 4AP, UK
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  • Strauss SJ
    Affiliations
    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
    Search for articles by this author
Published:August 12, 2022DOI:https://doi.org/10.1016/j.ejca.2022.06.036

      Highlights

      • Incidence and outcomes for breast sarcoma in England during 2013–2018.
      • Patients managed in specialist centres had differing outcomes.
      • No difference in survival between radiation and non-radiation induced vascular tumours.
      • We would recommend that all patients with breast sarcoma are discussed at a sarcoma MDT.

      Abstract

      Background

      Breast sarcomas (BS) are rare cancers originating from mesenchymal breast tissue with a paucity of national population level data detailing their incidence and outcomes.

      Methods

      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).

      Results

      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.

      Conclusion

      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.

      Keywords

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