Radiation-induced sarcoma after treatment of breast cancer

Senyszyn, John J.; Johnston, Austin D.; Jacox, Harold W.; Chu, Florence C. H.

doi:10.1002/1097-0142(197008)26:2<394::aid-cncr2820260221>3.0.co;2-f

Cited by 58 publications

(5 citation statements)

References 15 publications

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“…A long follow-up is necessary, the number of patients lost to follow-up must be low, and the number of survivors after radiation therapy must be sufficient. Others (17,18), however, have reported a lower incidence if all patients treated with radiation therapy are taken into account. For example, Phillips and Sheline (12) estimated a 0.23% frequency of sarcoma after irradiation for breast cancer.…”

Section: Discussionmentioning

confidence: 98%

Sarcoma after Radiation Therapy: Retrospective Multiinstitutional Study of 80 Histologically Confirmed Cases

Lagrange¹,

Ramaioli²,

Château³

et al. 2000

Radiology

176

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Section: Discussionmentioning

confidence: 98%

Sarcoma after Radiation Therapy: Retrospective Multiinstitutional Study of 80 Histologically Confirmed Cases

Lagrange¹,

Ramaioli²,

Château³

et al. 2000

Radiology

176

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“…Since then, the trend has been to narrow and focus the beam of radiation on the tumour and axillary nodes, thereby reducing even further the likelihood of direct exposure of the upper extremity to ionizing radiation. A direct relationship between radiation therapy and subsequent sarcoma of the chest wall itself is more likely and has been suggested previously (Senyszyn et al, 1970;Kim et al, 1978;Ferguson et al, 1984;Souba et al, 1986;Taghian et al, 1991;Wiklund et al, 1991), although the majority of reported post-radiation sarcomas have been malignant fibrous histiocytoma, osteosarcoma and fibrosarcoma, rather than angiosarcoma. We could not address this question directly in the absence of detailed treatment data.…”

Section: Discussionmentioning

confidence: 99%

The risk of angiosarcoma following primary breast cancer

et al. 1999

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Lymphangiosarcoma of the upper extremity is a rare and aggressive tumour reported to occur following post-mastectomy lymphoedema (Stewart–Treves syndrome). Haemangiosarcoma, a related rare tumour, has occasionally been reported to occur in the breast following irradiation. We conducted a case-control study using the University of Southern California-Cancer Surveillance Program, the population-based cancer registry for Los Angeles County, to evaluate the relationship between invasive female breast cancer and subsequent upper extremity or chest lymphangiosarcoma and haemangiosarcoma together referred to as angiosarcoma. Cases were females diagnosed between 1972 and 1995 with angiosarcoma of the upper extremity ( n = 20) or chest ( n = 48) who were 25 years of age or older and residing in Los Angeles County when diagnosed. Other sarcomas at the same anatomic sites were also studied. Controls were females diagnosed with cancers other than sarcoma during the same time period ( n = 266 444). Cases and controls were then compared with respect to history of a prior invasive epithelial breast cancer. A history of breast cancer increased the risk of upper extremity angiosarcoma by more than 59-fold (odds ratio [OR] = 59.3, 95% confidence interval [95% CI] = 21.9–152.8). A strong increase in risk after breast cancer was also observed for angiosarcoma of the chest and breast (OR = 11.6, 95% CI = 4.3–26.1) and for other sarcomas of the chest and breast (OR = 3.3, 95% CI = 1.1–1.7). © 1999 Cancer Research Campaign

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“…In studies that examine the incidence of sarcoma after RT, the estimated rate of occurrence lies between 0.017% and 0.17%. 3,4 The histologic subtypes of post-RT sarcoma include osteosarcoma (most common), malignant fibrous histiocytoma, angiosarcoma, lymphangiosarcoma, and spindle-cell sarcoma.…”

Section: Discussionmentioning

confidence: 99%

Angiosarcoma Causing Cardiac Constriction Late after Radiation Therapy for Breast Carcinoma

Sharma¹,

DeValeria²,

Scherber³

et al. 2016

Texas Heart Institute Journal

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P ericardial constriction remains a difficult diagnosis that requires a high degree of clinical suspicion, careful clinical examination, and multimodality imaging. The cause of the constriction can be challenging to ascertain and often becomes evident only at the time of surgical resection. Such is the case we present.Primary tumors of the pericardium are extremely rare, with an incidence of between 0.001% and 0.28% in an autopsy study 1 ; approximately 8% of those are angiosarcoma. In a study by Kirova and colleagues 2 of 16,705 patients who received radiation therapy (RT) for breast cancer, only 13 patients developed angiosarcoma of the breast, chest wall, or skin after a median follow-up period of 9.3 years. Pericardial angiosarcoma after RT is rare but has been described.1 To our knowledge, this is the 2nd report of angiosarcoma of the pericardium after RT. Case ReportA 41-year-old woman presented with 8 weeks of progressive dyspnea, orthopnea, and cough. Her history included intracystic papillary carcinoma of the left breast 8 years earlier (treated with lumpectomy and postoperative RT). The details of the protocol and dosage of radiation used during the treatment were not available. The physical examination was consistent with pleural and pericardial effusions. The white cell count was elevated, as were the serum creatinine level (2 mg/dL [normal range, 0.6-1.1 mg/ dL] and the blood urea nitrogen level (46 mg/dL [normal range, 6-21 mg/dL]). Her other laboratory tests-coagulation profile, autoimmune/rheumatologic disease assay, and urinalysis-were within normal limits. A chest radiograph revealed bilateral pleural effusions. Computed tomography (Fig. 1) revealed a large amount of pericardial fluid extending to the aortic root, with an increased density suggesting hemorrhage or high protein content and a possible anterior mass over the right atrium, thought to represent an ill-defined mass or organized hematoma and pleural effusions.Transthoracic echocardiography revealed preserved left ventricular ejection fraction, diastolic dysfunction, bilateral pleural effusions, and evidence of effusive-constrictive pericarditis. Thoracocentesis and pericardiocentesis through a pericardial window revealed no malignant cells. Laboratory evaluation of the effusions for autoimmune and rheumatologic disease was negative.The patient underwent open-chest pericardiectomy for constrictive pericarditis. On the visceral pericardium, there were nodular masses-7-mm thick, rubbery, and dark red-brown-adherent to the parietal pericardium.Microscopically, these were spindle-cell neoplastic cells with marked nuclear pleomorphism, consistent with angiosarcoma (Fig. 2). The malignant cells expressed vimentin, factor VIII, podoplanin, and CD31, with focal expression of CD34. The

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Radiation-induced sarcoma after treatment of breast cancer

Cited by 58 publications

References 15 publications

Sarcoma after Radiation Therapy: Retrospective Multiinstitutional Study of 80 Histologically Confirmed Cases

Sarcoma after Radiation Therapy: Retrospective Multiinstitutional Study of 80 Histologically Confirmed Cases

The risk of angiosarcoma following primary breast cancer

Angiosarcoma Causing Cardiac Constriction Late after Radiation Therapy for Breast Carcinoma

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