Grade and Prognosis in Localized Primary Angiosarcoma

Pandey, Manjari; Sutton, G.; Giri, Smith; Martin, Mike G.

doi:10.1016/j.clbc.2014.12.009

Cited by 23 publications

(30 citation statements)

References 15 publications

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“…In the current series, the mean age was 62. In contrast, primary angiosarcoma generally occurs in women in the 3rd to 4th decades, with the peak incidence between 30 and 50 . The oldest of the 3 women in this series with primary angiosarcoma was 39.…”

Section: Discussionmentioning

confidence: 64%

Distinguishing papillary endothelial hyperplasia and angiosarcoma on core needle biopsy of the breast: The importance of clinical and radiologic correlation

et al. 2018

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Papillary endothelial hyperplasia (PEH) is a rare non-neoplastic exuberant organizing hematoma that can closely mimic angiosarcoma due to a resemblance to malignant anastomosing blood vessels. It could be particularly difficult to distinguish PEH from angiosarcoma in breast core needle biopsies. We identified all cases of these lesions diagnosed on core needle biopsy in order to identify clinical, radiologic, and pathologic features that could prove helpful to arrive at the correct diagnosis. Four cases of PEH and 4 cases of angiosarcoma were identified. The mean age at diagnosis was 62 for PEH and 33 for primary angiosarcoma. All cases of PEH formed small masses with circumscribed or lobulated margins by imaging (mean size 0.9 cm). In 3 cases, the masses were difficult or impossible to identify after the biopsy. Angiosarcomas presented as larger masses with ill-defined margins (mean size 2.8 cm) that were unchanged in size after biopsy. PEH was surrounded by adipose tissue, whereas angiosarcoma invaded into fibrous stroma and involved lobules. The pseudopapillary structures of PEH were composed mainly of collagen, and thus, additional histologic stains for fibrin were not helpful for diagnosis. The 4 patients with PEH received no further treatment and are alive and disease-free at 2-11 years of follow-up. In contrast, the patients with angiosarcoma underwent mastectomy and chemotherapy or radiation therapy. Two of the patients with angiosarcoma died 3 years after diagnosis and the other 2 patients are alive without disease at 5 and 6 years. Therefore, distinguishing PEH and angiosarcoma is essential for appropriate management. This is the first series to compare these lesions on core needle biopsy and the first to note important clinical, imaging, and histologic differences that aid in making a diagnosis of PEH with confidence on breast core needle biopsy.

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Section: Discussionmentioning

confidence: 64%

Distinguishing papillary endothelial hyperplasia and angiosarcoma on core needle biopsy of the breast: The importance of clinical and radiologic correlation

et al. 2018

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“…High histologic grade of PAOB was frequently reported to be an unfavorable prognostic factor in retrospective series and population-based studies. 13 , 18 , 22 As described by Rosen et al, 23 5-year DFS was 76% in grade 1 tumor and dramatically fell to 15% in grade 3 tumors. Consistently, our findings indicated significantly better survival in patients with low histologic grade, as shown in Table 2 .…”

Section: Discussionmentioning

confidence: 82%

“…As for the adjuvant therapy, including chemotherapy and RT, the clinical benefit varied in different reports and no definite advantages were found. 12 , 13 , 25 – 27 Chemotherapy regimens were mostly extrapolated from soft tissue sarcomas of different origins. Target therapies, such as antiangiogenesis agents or molecular inhibitors, were investigated in only selective patients, as described in case reports or series.…”

Section: Discussionmentioning

confidence: 99%

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Management experiences of primary angiosarcoma of breast: a retrospective study from single institute in the People’s Republic of China

Hu¹,

Xin²,

Yan³

et al. 2015

OTT

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BackgroundPrimary angiosarcoma of breast (PAOB) is a rare and highly aggressive malignancy. There is no general agreement on optimal treatments or prognostic factors for this orphan disease. The objective of this study was to investigate the clinicopathologic features and management experiences of PAOB.MethodsWe performed a retrospective review of medical and pathologic records of 17 consecutive patients diagnosed with PAOB between January 2000 and February 2014 at FuDan University Shanghai Cancer Center. We evaluated the clinical characteristics, multimodality treatments, and associated clinical outcomes.ResultsA total of 16 patients were included in this retrospective study (median age at PAOB presentation 33.5 years, range: 19–56 years). Palpable tumor with or without breast skin ecchymosis presented as the most common initial symptom. All patients underwent surgery with curative intent. Median disease-free survival and overall survival (OS) were 9 months and 13.6 months, respectively. One-year and 3-year disease-free survival rates were 43.8% and 6.3%, with OS rates of 93.8% and 78.1%, respectively. High histologic grade indicated poorer OS by univariate analysis (P=0.01). However, neither adjuvant chemotherapy nor radiotherapy contributed to clinical outcomes in our series.ConclusionPAOB is considered as an infrequent breast neoplasm with aggressive characteristics. Histologic grade and early metastasis (within 12 months after diagnosis) are associated with poor prognosis. Regardless of grade, additional benefit was not observed with adjuvant therapy.

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“…The SEER database revealed that the histologic grade is a significant predictor of survival for patients with localized primary breast angiosarcoma (a study about 226 patients) [13]. However, another study interesting 49 cases of primary angiosarcoma suggested that histologic grade is not prognostic [14].…”

Section: Discussionmentioning

confidence: 99%

Breast angiosarcoma: A case report

Ayadi¹,

Berrazaga²,

Adouni³

et al. 2017

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review

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Grade and Prognosis in Localized Primary Angiosarcoma

Cited by 23 publications

References 15 publications

Distinguishing papillary endothelial hyperplasia and angiosarcoma on core needle biopsy of the breast: The importance of clinical and radiologic correlation

Distinguishing papillary endothelial hyperplasia and angiosarcoma on core needle biopsy of the breast: The importance of clinical and radiologic correlation

Management experiences of primary angiosarcoma of breast: a retrospective study from single institute in the People’s Republic of China

Breast angiosarcoma: A case report

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Grade and Prognosis in Localized Primary Angiosarcoma

Cited by 23 publications

References 15 publications

Distinguishing papillary endothelial hyperplasia and angiosarcoma on core needle biopsy of the breast: The importance of clinical and radiologic correlation

Distinguishing papillary endothelial hyperplasia and angiosarcoma on core needle biopsy of the breast: The importance of clinical and radiologic correlation

Management experiences of primary angiosarcoma of breast: a retrospective study from single institute in the People&rsquo;s Republic of China

Breast angiosarcoma: A case report

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Management experiences of primary angiosarcoma of breast: a retrospective study from single institute in the People’s Republic of China