ABSTRACT
Breast sarcomas, comprise a rare and diverse group of mesenchymal-derived neoplasias, accounting for 0.5% to 3% of malignant breast tumors. This overview explores primary and secondary forms, with primary sarcomas linked to genetic conditions like Li–Fraumeni syndrome and environmental exposures. Secondary sarcomas, notably angiosarcoma, often arise post-radiation therapy. Clinical presentation involves a unilateral, rapidly growing breast mass, distinct from epithelial cancer. Diagnosis relies on triple assessment, incorporating imaging and core needle biopsy.Surgery remains the mainstay, with considerations for wide local excision or mastectomy, the latter preferred for aggressive subtypes like angiosarcoma. Axillary nodal dissection is rarely warranted. Adjuvant therapies, controversial in primary sarcomas, include radiation and chemotherapy, individually tailored based on tumor characteristics. Neoadjuvant therapy may be considered for unresectable tumors. Follow-up schemes depend on disease stage, emphasizing history, physical examination, and imaging.Prognosis varies, with five-year survival rates ranging from 44% to 66%. Positive surgical margins and aggressive histologic subtypes impact outcomes. Locally recurrent disease is common, often curable with surgery, while metastatic cases may benefit from palliative chemotherapy. Radiation-associated sarcomas exhibit worse outcomes.In conclusion, managing breast sarcomas demands a nuanced, multidisciplinary approach, considering tumor heterogeneity, patient factors, and evolving treatment paradigms. This abstract provides a succinct overview, highlighting diagnostic modalities, treatment strategies, and prognostic considerations in navigating this uncommon malignancy.
