Abstract / Summary
Abstract Background: Breast sarcoma resection can require extensive reconstruction. We examined reconstructive procedures, subsequent surgery and long-term survival in a breast-specific institutional cohort that included malignant phyllodes tumors. Methods: We reviewed 26 records of breast sarcoma or phyllodes tumor. Twenty patients, including two with malignant phyllodes tumors, had dated tumor resections and entered the operative and survival analyses. Reconstructive procedures and subsequent operations were classified from operative summaries. Overall survival was estimated from the first recorded tumor resection using Kaplan–Meier methods, with sensitivity analyses addressing histologic composition and an incomplete follow-up date. Results: The complete series included nine angiosarcomas, three phyllodes tumors and 14 other sarcomas. All 20 operative patients achieved R0 resection; median age was 55.0 years. Initial coverage used flaps in 13 patients, skin grafts in three and primary closure in one; the method was unspecified in three. Fourteen patients had a flap documented during their operative course. Six deaths occurred. Median follow-up estimated by reverse Kaplan–Meier was 15.0 years. Five- and ten-year overall survival were 82.0% (95% confidence interval 53.5–93.9) and 74.5% (44.9–89.8), respectively. Excluding dermatofibrosarcoma protuberans, ten-year survival was 68.1% (34.7–87.0). Recurrence annotations were present in six patients. Complete excision of the irradiated field could not be established from the operative summaries. Conclusions: Frequent flap use and survival beyond a decade support considering long-term survivorship when planning breast sarcoma reconstruction. Histologic composition influences pooled survival estimates. Resection extent and reconstructive method require separate documentation to evaluate outcomes after irradiated-field excision.