A retrospective review of 58 rare breast neoplasms encountered at the British Columbia Cancer Agency between 1972 and 1992 was undertaken. There were 38 cystosarcoma phyllodes tumors, 6 carcinosarcomas, and 14 other sarcomas. Initial management involved total mastectomy in 37 cases, wide excision in 14, and excision biopsy in 7. Recurrence developed in 19 patients. Local recurrence developed in 7 patients following mastectomy, 2 incidences following wide excision, and 2 following excision biopsy. There was no significant difference in recurrence in relation to the surgical approach. Tumor grade was a significant predictor for metastatic recurrence but not for local recurrence. Adequate surgical excision remains the only curative therapy for these rare tumors. In selected cases, partial mastectomy is an acceptable treatment.