Management of radiation-induced sarcomas in a tertiary referral centre: A review of 25 cases

Erel, Ertan; Vlachou, Eugenia; Athanasiadou, María; Hassan, S.; Chandrasekar, C. R.; Peart, F.

doi:10.1016/j.breast.2010.04.006

Cited by 29 publications

(49 citation statements)

References 14 publications

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“…As with primary sarcoma patients, surgery remains crucial as the primary therapy for RIS [28]. For patients with nonmetastatic RIS, aggressive resection with widely negative margins is necessary [5,30]. If the tumor infiltrates beyond the breast into the chest wall, then chest wall excision may also be required to achieve an R0 resection [30].…”

Section: Discussionmentioning

confidence: 99%

“…Blanchard et al [18] reported that patients with a smaller mean tumor size had fewer local recurrences than patients with larger tumors. Local recurrence rates after surgical therapy alone were high, in the range of 50%-68% [5].…”

Section: Prognosismentioning

confidence: 99%

“…However, the overall role of chemotherapy in RIS treatment remains to be determined by additional clinical trials. With the development of novel chemotherapeutic agents, a combined approach may ultimately increase the probability of survival for RIS patients [5,113,117].…”

Section: Role Of Chemotherapymentioning

confidence: 99%

“…A proper surgical approach is crucial to decreasing the risk for recurrence; one study suggested that, for optimal margin control, the surgeon should extirpate one plane beyond the anatomic plane of known disease [5]. En bloc chest wall excision was necessary in some patients, such as those with tumors in previously radiated fields, with extensive disease infiltration [30].…”

Section: Treatmentmentioning

confidence: 99%

“…After radiotherapy, the cumulative RIS incidence is 3.2 per 1,000 at 15 years (versus 2.3 per 1,000 for primary sarcoma in a population without radiotherapy) [2]. The occurrence rate of RIS is low: over a 10-year period, 0.03%-0.2% [3][4][5][6][7][8]. RIS comprises about 3% of all soft-tissue sarcomas [9].…”

Section: Introductionmentioning

confidence: 99%

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Radiation-Induced Sarcoma of the Breast: A Systematic Review

et al. 2012

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After completing this course, the reader will be able to:1. Evaluate the level of evidence to inform decision making for the treatment radiation induced sarcoma of the breast.2. Explain diagnostic criteria for radiation-induced sarcoma.3. Describe the effectiveness of surgery, chemotherapy and radiation therapy for radiation induced sarcoma of the breast.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTIntroduction. Radiation-induced sarcoma (RIS) is a rare, aggressive malignancy. Breast cancer survivors treated with radiotherapy constitute a large fraction of RIS patients. To evaluate evidenced-based practices for RIS treatment, we performed a systematic review of the published English-language literature. Methods. We performed a systematic keyword search of PubMed for original research articles pertaining to RIS of the breast. We classified and evaluated the articles based on hierarchal levels of scientific evidence.Results. We identified 124 original articles available for analysis, which included 1,831 patients. No randomized controlled trials involving RIS patients were found. We

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Section: Discussionmentioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

Section: Role Of Chemotherapymentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Radiation-Induced Sarcoma of the Breast: A Systematic Review

et al. 2012

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Impact of specialist management on survival from radiation-associated angiosarcoma of the breast

Feinberg

Srinivasan

Singh

et al. 2018

British Journal of Surgery

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Radiation‐associated sarcoma after breast cancer in a nationwide population: Increasing risk of angiosarcoma

et al. 2018

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Radiation‐associated sarcoma (RAS) is a rare complication of radiation therapy (RT) to breast cancer (BC). This study explored RAS after RT to BC in a nationwide population‐based material. The Finnish Cancer Registry was queried for patients with BC treated during 1953‐2014 who were later diagnosed with a secondary sarcoma in 1953‐2014. Registry data, patient files, and sarcoma specimens were analyzed to confirm diagnosis and location of RAS at or close to the RT target volume. A total of 132 512 patients were diagnosed with invasive BC during the study period. A subsequent sarcoma was diagnosed in 355 patients. After exclusion, 96 RAS were identified. Angiosarcoma (AS) was the most prevalent histology in 50 (52%) of 96 patients. However, the first radiation‐associated AS was diagnosed in a patient treated for BC with breast‐conserving surgery in 1984, and thereafter, the proportion of AS continuously increased. The 5‐year sarcoma‐specific survival was 75.1% for RAS treated with a curative intent. The distribution of histologic subtypes of RAS has changed during the 60 years of this registry study. The first radiation‐associated AS was diagnosed in 1989, and presently, AS is the most common histologic subtype of RAS. It is possible that changes in BC treatment strategies are influencing the characteristics of RAS.

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Management of radiation-induced sarcomas in a tertiary referral centre: A review of 25 cases

Abstract: Radiation-induced sarcoma following breast cancer has high local recurrence rate and poor prognosis. They should be managed in a multi-disciplinary setting. Long-term follow-up of patients treated with radiotherapy for breast cancer is therefore advisable.

Cited by 29 publications

References 14 publications

Radiation-Induced Sarcoma of the Breast: A Systematic Review

Radiation-Induced Sarcoma of the Breast: A Systematic Review

Impact of specialist management on survival from radiation-associated angiosarcoma of the breast

Radiation‐associated sarcoma after breast cancer in a nationwide population: Increasing risk of angiosarcoma

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