Malignant Mesenchymal Tumors of the Breast: Current Challenges and New Perspectives

Mesenchymal tumors of the breast represent a rare and diverse group of neoplasms, accounting for 0.5% of all breast tumors. These tumors originate from the mesenchymal tissues of the breast and encompass a variety of histological subtypes. Malignant mesenchymal tumors are particularly aggressive, characterized by a high propensity for local recurrence and an overall poor prognosis. The rarity of these cases has hindered the development of robust clinical studies, resulting in a lack of standardized diagnostic and treatment guidelines and considerable variability in clinical management. This review offers a comprehensive synthesis of the current understanding of breast mesenchymal tumors, with a primary focus on malignant variants, including phyllodes tumors and breast sarcomas. It explores the diagnostic challenges, evaluates existing therapeutic approaches, and highlights the central role of surgical management while examining the evolving roles of chemotherapy and radiotherapy in improving patient outcomes.