Highlights
- •Primary breast sarcoma was associated with better overall survival compared to secondary breast sarcoma.
- •About 60% of patients with secondary breast sarcoma received radiation for their primary tumors.
- •Surgery was associated with better overall survival for primary and secondary sarcoma patients.
- •Radiation and chemotherapy did not show significant improvement in survival of patients with primary and secondary breast sarcoma.
- •Factors associated with worse survival of patients with primary breast sarcoma included being unmarried, age > 60 years and tumor size > 50 mm.
- •The created and validated nomograms showed a good performance with C index of 0.71 for primary breast sarcoma and 0.69 for secondary breast sarcoma.
Abstract
Background
Breast sarcoma is one of the rare types of breast tumors with different features and
outcomes compared to carcinoma. Our study aims to describe the clinical and pathological
characteristics of primary breast sarcoma (PBS) and secondary breast sarcoma (SBS)
along with determining prognostic factors and developing nomograms for predicting
survival.
Methods
Using the Surveillance, Epidemiology, and End Results (SEER) Program, female patients
diagnosed with breast sarcoma between 1975 and 2016 were identified. Cox regression
was used to evaluate the association between survival and clinical features.
Results
Out of 1334 included patients, 816 had PBS and 518 had SBS. PBS had a significantly
better overall survival than SBS with median survival months of 107 for PBS and 45
for SBS. The primary tumor site did not have a significant impact on the survival
of SBS. Cox regression showed worse survival of PBS patients who were > 60 years (HR
3.04, 95% CI 2.46-3.74) and had tumor size > 50 mm (HR 2.01, 95% CI 1.61-2.51). Being
not married was associated with worse survival of PBS (HR 1.29, 95% CI 1.06-1.56)
and SBS (HR 1.50, 95% CI 1.19-1.90). Surgery was associated with better survival of
PBS (HR 0.60, 95% CI 0.42-0.85) and SBS (HR 0.46, 95% CI 0.31-0.68). The C-indexes
of created nomograms were 0.73 for PBS and 0.69 for SBS.
Conclusion
Age and size were the most important prognostic factors for the survival. Surgery
was associated with better survival. However, radiation and chemotherapy did not show
significant improvement in survival.
Keywords
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Article Info
Publication History
Published online: July 22, 2022
Accepted:
July 17,
2022
Received in revised form:
June 15,
2022
Received:
April 11,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
