Introduction/Background Breast sarcomas are a rare and heterogeneous group of malignant neoplasms that account for less than 1% of all breast cancers. Although surgery is considered the gold standard treatment, the management of adjuvant therapy remains controversial and uncertain. The objective of our work is to evaluate the therapeutic modalities of breast sarcomas by analyzing local experience.

Methodology We conducted a descriptive retrospective study of 14 cases of breast sarcoma treated at the Farhat Hached Hospital oncological radiotherapy department in Sousse, Tunisia, between 1995 and 2020. We analyzed patient characteristics, surgical procedures, and adjuvant therapy modalities.

Results We identified 14 cases of non-metastatic breast sarcomas, including 10 cases of phyllodes sarcomas and 4 cases of non-phyllodes sarcomas. The median age was 41.4 years, and 8 patients were premenopausal. Benign breast pathologies were observed in 7 patients, while 5 patients had inflammatory skin signs. The median tumor size was 10.25 cm. All patients underwent mastectomy, with 7 also undergoing lymph node resection. Adjuvant therapy included radiotherapy for all patients and chemotherapy for 7 patients, except for one case already irradiated. The median radiation dose was 50 Gy in 25 fractions, with additional dose in 4 patients. A local recurrence was observed in one patient, while 5 patients developed metastases. The time to onset of metastases varied between 2 months and 5 years. However, 6 patients achieved complete remission with follow-up ranging from 4 to 20 years. Two patients were lost to follow-up, and the patient with radiation-induced sarcoma died shortly after surgery.

Conclusion Breast sarcomas are rare and aggressive tumors with poorly codified therapeutic management. A multidisciplinary approach is crucial for decision-making.

Disclosures There are no financial conflicts of interest to disclose