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

Abstract

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.

Primary breast angiosarcoma: A case report

“…While some studies indicate that partial or total mastectomy does not significantly affect patient survival time, [12,13] other studies present conflicting outcomes, suggesting that patients undergoing breast-conserving surgery experience longer overall survival. [14,15] This discrepancy might stem from the fact that patients undergoing breast-conserving surgery have smaller tumors, an earlier clinical stage, and a higher likelihood of achieving negative margins. PBA diagnosis frequently occurs at advanced stages with extensive tumor infiltration, posing challenges in attaining negative margins through wide local excision, resulting in a heightened postoperative local recurrence rate.…”

“…Current research indicates a median survival time of 38 months, with 1-, 3-, and 5-year overall survival rates of 80%, 39%, and 25% respectively. [ 14 ] Prognostic factors identified include tumor histological grade, staging, size, and surgical margins. [ 15 , 24 ] In this case, the patient exhibited poor histological differentiation, a large tumor infiltrating the pectoralis major muscle, an early disease onset, and recurrence within 10 months postoperatively, ultimately succumbing to hemorrhage from tumor recurrence at 18 months.…”