NON-EPITHELIAL PRIMARY BREAST NEOPLASMS: THE PREVALENCE AND MANAGEMENT OF A RARE CONDITION IN A SINGLE INSTITUTION OVER A 23 YEAR PERIOD


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Jack Nolan1,Liam Devane2,Chwanrow Baban2,Jane Rothwell2,Denis Evoy2,James Geraghty2,Anne O'Doherty2,Cecily Quinn2,Clare D'arcy2,Enda McDermott2,Ruth Prichard2
1St. Vincent's University Hospital Dublin,2St. Vincent's University Hospital

Abstract

Background

Primary non-epithelial breast neoplasms incorporating lymphoma, sarcoma and fibromatosis, are rare occurrences representing less than 0.5% of all primary tumours of the breast. The aim of this study was to assess their prevalence, management and prognostic features over a 23-year period in our institution.

Method

The hospital histopathologic database was interrogated for all reports containing the above diagnoses over the past 23 years (1993-2016). Histology reports, patient imaging and charts were reviewed to collect data on demographics, diagnosis, treatment and recurrence.

Results

A total of 33 patients (or 0.46%) were found to have primary non-epithelial type tumours, comprising 8 patients with primary breast sarcoma, 9 patients with breast fibromatosis and 16 with primary breast lymphoma (n=7171). All but one were female with a mean age at diagnosis was 56.57 years (range: 21-82). Presentation and treatment differed according to each subset, with surgery being the primary intervention for fibromatosis and sarcoma, and chemotherapy the primary treatment for lymphoma.

Conclusion

Each subset carries a different clinical profile, presentation, interventional options and prognosis. Surgery remains the only potentially curative option for primary breast sarcoma, with our data supporting the evidence that tumour size and not grade is associated with overall survival. Breast fibromatosis is difficult to differentiate from breast cancer without excision and histopathological analysis. It is not invasive; however our data confirm the propensity for local recurrence. Primary breast lymphomas are similar to lymphomas elsewhere and mastectomy is not thought to be of benefit, with chemotherapy +/- radiotherapy offering best management.