Outcome and prognostic factors in breast sarcoma: A multicenter study from the rare cancer network
ABSTRACT Breast sarcoma (BS) is a rare tumour. While surgical resection is the primary treatment, the role of radiation therapy (RT) and chemotherapy remains unclear. This study aimed at defining prognostic factors and treatment strategies.
Data from 103 patients treated between 1976 and 2002 were collected. The median age was 55 years (range: 13-86); the median histological tumour size was 4.45 cm (range: 0.8-22). There were 42 angiosarcomas. Surgery consisted of wide excision in 34 cases, and total mastectomy in 69 cases. A total dose of 50 Gy in 25 fractions was delivered in 50 patients. At the completion of treatment, 89 patients had no residual tumour.
After a median follow-up of 64 months, 56 patients developed recurrent disease: 38 presented a local relapse and 37 developed distant metastases. The 5-year disease-free survival (DFS) and overall survival (OS) were 44% (95% confidence interval [CI], 39-49%) and 55% (95% CI, 50-60%), respectively. In multivariate analysis, favourable prognostic factors for better local control were: no residual tumour after treatment, no cellular pleomorphism, and histology other than angiosarcoma. For DFS, the five favourable prognostic factors were non-menopausal status, no residual tumour after treatment, non-angiosarcoma histology, absence of tumour necrosis, and grade 1-2 histology.
While angiosarcoma has the worst prognosis, the outcome of the other types of sarcomas may be worsened by residual tumour after loco-regional treatment and high grade histology, a classical prognostic factor of the other soft tissue sarcomas. During surgical procedure axillary dissection is not mandatory.
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ABSTRACT: Among angiosarcomas, radiation-induced breast sarcomas (RIBS) represent a well-known entity generally characterized by a poor outcome, especially in patients with advanced disease. Despite the unfavorable prognosis, some chemotherapeutic agents have been used to treat these malignancies, occasionally with success. Treatments with demonstrated activity against sarcomas include ifosfamide-based regimens and, more recently, taxane derivatives. We report a case of a patient having a secondary breast angiosarcoma recurring early after surgery, who achieved complete remission following treatment with weekly paclitaxel. After 4 years of maintenance therapy, with an interval between consecutive administrations of no longer than 3 weeks, the patient is still in complete remission. A locoregional recurrence was documented twice during this period, the first as a consequence of a brief treatment interruption and the second because of a treatment delay. Nonetheless, in both instances a new complete remission was rapidly achieved with the resumption of the same treatment, without evidence of any significant adverse effects. We discuss the highly unusual behavior of this malignancy and the possible role of the two different mechanisms of action of paclitaxel-antiangiogenic versus cytotoxic-depending on the schedule of administration, with evidence of "false" drug-resistance.Tumori 95(6):828-31. · 1.09 Impact Factor
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ABSTRACT: ObjectiveTo investigate the clinical and pathological characteristics, diagnosis and treatment of stromal sarcoma of the breast (SSB). Methods: The clinical and pathological data of 6 patients with SSB treated between 1954 and 2007 were retrospectively analyzed. MethodsThe clinical and pathological data of 6 patients with SSB treated between 1954 and 2007 were retrospectively analyzed. ResultsAll patients were female and one was menopausal. The median age of the patients was 39 years old (range, 20–55). All cases had a history of a palpable mass. The tumor rapidly augmented in a short time period in 3 patients. One patient had discontinuous pain and 3 patients had masses located in the upper outer quadrant of the breast. The median tumor radius was 6.0 cm (range, 3–15 cm). According to the AJCC breast cancer staging standard (6th edition), 1 case was of stage IIA, 2 cases were of stage IIB, 2 cases were of stage IIIB and one case couldn’t be staged. Four patients were initially treated by excising the tumor and then undergoing mastectomy or modified radical mastectomy after recurrence. Radical mastectomy was suitable for those with pectoralis major muscle involvement. Two patients received simple mastectomy, 2 patients underwent radical mastectomy and another 2 patients received modified radical mastectomy. After surgery, all patients were identified as SSB through pathology, with focal ossification in one case and mucinous degeneration in another one case. Four patients who underwent axillary lymph node dissection did not have lymph node metastases. Three patients received chemotherapy after surgery. After a median follow-up time of 36.5 months (8–204 months), 4 patients had recurrence after local excision and 3 patients had recurrence more than 2 times with a median time to recurrence of 2.5 months (1 to 4 months) after surgery. One patient had lung metastases at 7 months after the initial surgery and the other 5 patients were alive without disease at the end of the follow-up period. ConclusionSSB is difficult to diagnose preoperatively and is characterized by its tendency to recur locally. To obtain negative margins, wide local excision or mastectomy must be performed. Axillary lymph node dissection is not mandatory. The roles of adjuvant chemotherapy and radiotherapy have still been controversial.Clinical Oncology and Cancer Research 04/2009; 6(2):147-151. DOI:10.1007/s11805-009-0147-2
Conference Paper: A visual interaction system using real-time face tracking[Show abstract] [Hide abstract]
ABSTRACT: This paper describes a new method for pose estimation of a human face moving abruptly in the real world and its hardware implementation for real-time operation. The virtues of this method are the use of very simple calculation, the correlation among multiple model images, and the absence of any facial features such as facial organs, so that it is very robust and can be easily implemented with simple hardwareSignals, Systems and Computers, 1994. 1994 Conference Record of the Twenty-Eighth Asilomar Conference on; 01/1994