Angiosarcoma after conservation treatment for breast carcinoma: Our experience and a review of the literature

Fodor, János; Orosz, Zsolt; Szabó, Éva; Sulyok, Zoltán; Polgár, Csaba; Zaka, Zoltán; Major, Tibor

doi:10.1016/j.jaad.2005.10.017

Cited by 91 publications

(69 citation statements)

References 42 publications

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“…The estimated risk of metastases for soft tissue sarcoma has been estimated to be as high as 50%. Some studies suggest that treatment with anthracycline-based chemotherapy can improve both disease free survival (DFS) and overall survival (OS) (8). A meta-analysis of patients treated with doxorubicin and a randomized trial of epirubicin plus ifosfamide demonstrated longer DFS and OS (26,27).…”

Section: Adjuvant Treatmentmentioning

confidence: 99%

“…A meta-analysis of patients treated with doxorubicin and a randomized trial of epirubicin plus ifosfamide demonstrated longer DFS and OS (26,27). The rate of delivery of chemotherapy can range from 0% to 65% and selection bias of treating more high risk or high grade patients cannot be ruled out (8). In at least two studies, adjuvant chemotherapy had no effect on recurrence free survival or OS (28,29).…”

Section: Adjuvant Treatmentmentioning

confidence: 99%

“…The median latency to presentation after radiotherapy in seven series ranges from 5 to 10 years (1). Although a causal relationship between radiation exposure and AS has not been established, multiple case reports support the increased risk for AS following adjuvant radiotherapy (7)(8)(9). It has been proposed that at radiation doses >50 Gy apoptosis occurs while at <50 Gy DNA damage and instability result.…”

Section: Introductionmentioning

confidence: 99%

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Primary and Secondary Angiosarcoma of the Breast

2016

Contemporary Diagnostic Radiology

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Angiosarcoma is a rare soft tissue tumor of the breast. It occurs in both a primary form without a known precursor, and a secondary form that has been associated to a history of irradiated breast tissue. These forms differ in many ways including median age, precipitating factors, and presentation. Both forms have a malignant behavior and a poor prognosis. The endeavor of this paper is to review what is known about the presentation, diagnostic and therapeutic modalities to date.

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Section: Adjuvant Treatmentmentioning

confidence: 99%

Section: Adjuvant Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary and Secondary Angiosarcoma of the Breast

2016

Contemporary Diagnostic Radiology

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“…Angiosarcomas are one histological subtype of radiationinduced sarcomas, and although a very rare complication, they are significant due to their poor overall prognosis (5)(6)(7). Characterised by rapid proliferation and extensive infiltrating growth, these malignant tumours of the vascular endothelium typically follow an aggressive course with difficulty clearing surgical margins and controlling distant spread.…”

Section: Introductionmentioning

confidence: 99%

A radiation-induced and radiation-sensitive, delayed onset angiosarcoma arising in a precursor lymphangioendothelioma

et al. 2017

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An 83-year-old female was treated with mastectomy and postoperative radiotherapy for breast cancer 30 years prior to developing a new small patch of thickening and scaliness on her left upper back, within the previous radiotherapy field. Serial excision biopsies revealed this to be a lymphangioendothelioma with no suggestion of malignancy. In early 2006 the lesion began to enlarge and take on a more erythematous plaque-like appearance. She was reviewed by a specialist dermatologist and an excision biopsy revealed a low-grade cutaneous angiosarcoma; this was approximately 38 years after radiotherapy to this region, the longest reported period between irradiation and in-field angiosarcoma development (the previous being 16 years). To our knowledge, this is the first case of post-radiotherapy angiosarcoma with a diagnosed precursor lesion. The lesion was treated with surgical excision and adjuvant radiotherapy. After further in-and out of-field recurrences, low dose radiotherapy elicited a surprisingly rapid and complete response within the treated areas; this was unusual in that these tumours are characteristically radiation-resistant. The radiosensitive case we report here raises the possibility that radiation should be more widely considered in the therapy of this disease. Methods of treatment of this rare malignancy are discussed.

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“…Even after mastectomy, radiotherapy has been thought to be beneficial for patient with microscopically positive margins. 12 The prognosis, however, remains poor despite early diagnosis and treatment. The overall 5 year survival ranges from 8-50%.…”

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confidence: 99%

Primary angiosarcoma of the breast: a rare entity

et al. 2017

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Primary angiosarcoma of the breast is a rare form of breast cancer, accounting for only 0.04% of all malignant breast tumours. We report a 35-year-old woman who presented with a recurrent lump in the left breast for four months. Fine needle aspiration cytology (FNAC) was suspicious of angiosarcoma and this diagnosis was confirmed on core needle biopsy. Modified radical mastectomy was performed as sole treatment. No chemo radiotherapy was given as tumor was grade I, margins were negative and there was no lymph node involvement. She is on regular follow up and no recurrence reported since the surgery. The 5-year disease-free survival for grade I tumours can be as high as 76%, and up to 70% for grade II tumours whereas for grade III tumours it is reportedly about 15%. Primary angiosarcoma of the breast is a rare malignancy with a poor prognosis, even after complete resection. Surgery is the mainstay of treatment with a limited role for chemotherapy and radiotherapy.

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Angiosarcoma after conservation treatment for breast carcinoma: Our experience and a review of the literature

Cited by 91 publications

References 42 publications

Primary and Secondary Angiosarcoma of the Breast

Primary and Secondary Angiosarcoma of the Breast

A radiation-induced and radiation-sensitive, delayed onset angiosarcoma arising in a precursor lymphangioendothelioma

Primary angiosarcoma of the breast: a rare entity

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