Sarcomas of the breast: findings on mammography, ultrasound, and magnetic resonance imaging

Sarcomas of the breast belong to a heterogeneous group of breast tumors of mesenchymal origin, without epithelial components. These tumors can be primary or secondary (after previous treatment for breast cancer), are rare, present aggressive behavior, and have a poor prognosis. They occur mainly in women between 45 and 50 years of age, with the exception of angiosarcomas, which can occur in younger patients. Clinically, breast sarcomas manifest as palpable, mobile, rapidly growing masses, without skin thickening, axillary lymphadenopathy, or nipple discharge. Although the imaging findings are non specific, they can be suggestive of sarcoma. For instance, a solitary mass showing rapid growth, with circumscribed or indistinct margins and, a complex (solid-cystic) or heterogeneous echotexture, without axillary lymph node involvement, can raise the suspicion of sarcoma. The treatment is not well established, because of the rarity and heterogeneity of this type of neoplasm. The principles of treatment for sarcoma of the breast have been addressed only in small cohort studies. In most cases, the treatment of choice is surgery without axillary lymphadenectomy.