Breast angiosarcoma after primary breast cancer surgery: A systematic review

Sato, Fumiya; Yamamoto, T.

doi:10.1016/j.bjps.2022.06.046

Cited by 6 publications

(8 citation statements)

References 21 publications

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“…According to their previous Indocyanine Green lymphography staging of breast lymphedema, higher staging could be related to higher incidence of symptoms related to breast lymphedema 21 . Nevertheless, a review by Sato and Yamamoto described that postoperative lymphedema is not a significant prognostic factor for patients with secondary breast angiosarcoma 22 . The various possibilities need to be verified and their underlying mechanisms need to be clarified by further studies.…”

Section: Discussionmentioning

confidence: 98%

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Clinicopathological characteristics and survival outcomes in patients with angiosarcoma of breast

Wang

et al. 2023

Cancer Medicine

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Background: Angiosarcoma of the breast is a rare malignancy. There are little data evaluating the survival and estimating the prognostic factors. The best surgical management and the role of systemic adjuvant therapy remain ill-defined.This study aimed to investigate the clinicopathological features, survival, and prognostic factors of breast angiosarcoma. Methods:The data on patients diagnosed with breast angiosarcoma were extracted from the Surveillance, Epidemiology, and End Results database . Univariate and multivariate Cox regression analyses were used to estimate the influential prognostic factors. The overall survival (OS) and disease-specific survival (DSS) of patients with breast angiosarcoma were evaluated.Results: This study included 656 patients diagnosed with breast angiosarcoma between 1975 and 2016. The 5-year OS rate of all patients was 44.9% (95% CI 40.8-49.0). In both OS and DSS, Kaplan-Meier survival analyses revealed significant differences for both OS and DSS according to age, year at diagnosis, laterality, grade, and stage (all log-rank p < 0.05). Multivariate analysis suggested that lesions of the right breast, poor differentiation, and advanced stage were independent risk factors for OS or DSS (all p < 0.05). Older age was a risk factor in OS, but was protective in DSS. In primary breast angiosarcoma, age, laterality, grade, and stage were independent prognostic factors in OS and DSS (all p < 0.05).Mastectomy was also a risk factor in DSS (p = 0.034). The proportion of patients with grade III and regional disease was larger in the mastectomy group. Conclusion:Angiosarcoma of the breast had a poor prognosis. In our study, age, laterality, histologic grade, and stage were identified as significant prognostic factors. Why patients with angiosarcoma of the right breast had a worse prognosis remains equivocal. Mastectomy was adopted more often by surgeons in this cohort study for patients with advanced primary breast angiosarcoma.

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Section: Discussionmentioning

confidence: 98%

“… 21 Nevertheless, a review by Sato and Yamamoto described that postoperative lymphedema is not a significant prognostic factor for patients with secondary breast angiosarcoma. 22 The various possibilities need to be verified and their underlying mechanisms need to be clarified by further studies.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics and survival outcomes in patients with angiosarcoma of breast

Wang

et al. 2023

Cancer Medicine

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“…It has been shown that chronic lymphedema is an important risk factor for the development of angiosarcoma of the breast (STS), and fibrosis of the surrounding skin tissue caused by radiotherapy may be a factor in its development [ 23 ]. It is evident from previous cases that STS has a worse prognosis than other skin malignancies, and early diagnosis and treatment are imperative; however, STS is insidious, and many diagnoses rely on subjective assessment [ 24 , 25 ]. In recent years, studies have been performed using TDC and indocyanine green (ICG) lymphography to objectively assess the status of lymph node circulation, providing new ideas for early diagnosis of the disease [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological analysis and prognostic treatment study of angiosarcoma of the breast: a SEER population-based analysis

Yan

Yang

et al. 2023

World J Surg Onc

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Introduction Breast angiosarcoma is a rare malignancy of endovascular origin, accounting for less than 1% of all mammary cancers. Our aim was to explore clinicopathological features and the factors associated with prognosis. Methods We extracted information from the Surveillance, Epidemiology, and End Results Program (SEER) for all patients with breast angiosarcoma between 2004 and 2015. Chi-square analysis was used to compare the clinicopathological features in all patients. Overall survival (OS) was assessed using the Kaplan and Meier method. Univariate and multivariate analyses were performed to evaluate the factors associated with prognosis. Results A total of 247 patients were included in the analyses. The median OS of patients with primary breast angiosarcoma (PBSA) and secondary breast angiosarcoma (SBAB) was 38 months and 42 months, respectively. The 1-, 3- and 5-year OS with PBSA was 80%, 39%, and 25%, respectively, and the 1-, 3- and 5-year OS with SBAB was 80%, 42%, and 34%, respectively. Multivariate analysis revealed that tumor size (p = 0.001), tumor grade (p < 0.001), tumor extension (p = 0.015), and tumor spread (p < 0.001) were statistically significant factors for OS. Partial mastectomy with radiation (HR = 0.160, 95% CI, 0.036–0.719, p = 0.016), partial mastectomy with chemotherapy (HR = 0.105, 95% CI, 0.011–1.015, p = 0.052), and partial mastectomy (HR = 0.125, 95% CI, 0.028–0.583, p = 0.007) were related to significantly better OS outcomes in primary angiosarcoma. Conclusion Primary breast angiosarcoma has a better clinical phenotype than secondary breast angiosarcoma. Although overall survival was not statistically significant, primary breast angiosarcoma was better than secondary breast angiosarcoma with systemic therapy. Depending on the outcome of survival, partial mastectomy is effective in treating primary breast angiosarcoma.

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“…A differential diagnosis in breast angiosarcomas should be made mainly regarding other vascular lesions of the mammary gland, including hemangiomas and angiomatosis, endothelial papillary hyperplasia, sarcomatoid carcinomas, and sarcomas of the breast, where endothelial involvement should be evaluated. Additionally, pseudoangiomatous hyperplasia of the mammary stroma should be ruled out, which presents myofibroblastic proliferation as a characteristic [33].…”

Section: Discussionmentioning

confidence: 99%

Primary Breast Angiosarcoma: Comparative Transcriptome Analysis

Rincón-Riveros

Peña²,

Rubiano³

et al. 2022

IJMS

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Primary breast angiosarcoma, with de novo appearance and not associated with exposure to radiation or lymphedema, is a rare pathology representing less than 0.05% of the neoplasms related to this organ. The pathology is characterized by its aggressiveness, poor prognosis, and difficulties in its differential diagnosis. This article reports the case of a 55-year-old white woman with no family history of cancer, with a rapidly growing mass in the left mammary gland that ulcerates and bleeds. It is confirmed as primary breast angiosarcoma by immunostaining in the tumor tissue for CD31, CD34, and FLI-1. In addition, a sample of neoplastic and healthy tissues is collected from the patient for RNA sequencing; the results are contrasted with a tissue sample from a patient with Luminal A subtype of breast cancer, as well as data from other cases of angiosarcoma available in public databases. These findings revealed a genetic profile associated with the immune and inflammatory response in the patient’s sample when compared to available angiosarcoma data; these molecular patterns are consistent with other recent studies. Due to the rarity of the disease, the studies carried out on each patient contribute to the expanding knowledge of the etiology and molecular pathways that are still partially known and continue to be the subject of research. Aside from a comparative transcriptome study, this article aims to provide an update on the state of knowledge about this disease.

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Breast angiosarcoma after primary breast cancer surgery: A systematic review

Cited by 6 publications

References 21 publications

Clinicopathological characteristics and survival outcomes in patients with angiosarcoma of breast

Clinicopathological characteristics and survival outcomes in patients with angiosarcoma of breast

Clinicopathological analysis and prognostic treatment study of angiosarcoma of the breast: a SEER population-based analysis

Primary Breast Angiosarcoma: Comparative Transcriptome Analysis

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