Risk of Angiosarcoma Following Breast Conservation: A Clinical Alert

Abstract

Approximately 100 cases of angiosarcoma following breast-conserving therapy have been reported. The prevalence of angiosarcoma following breast conservation has not been accurately established and optimal treatment has not been defined. The goal of this article is to clarify both issues. The Fisher's exact test was used to compare the prevalence of postirradiation angiosarcoma seen in our private practice to the prevalence reported from the two largest national database studies. A literature review was performed to determine optimal treatment guidelines. The results of the comparison indicated that the prevalence of postirradiation angiosarcoma seen in our practice was significantly higher than that reported in the two national database studies at p-values of 0.0124 and 0.0080. Also, results from the literature review suggest that early detection and aggressive treatment lead to improved outcomes. The data are insufficient to draw firm conclusions, but suggest that the current literature underestimates the prevalence of angiosarcoma following breast-conserving therapy. Since elderly women derive less benefit from radiation and may be more prone to develop postirradiation angiosarcoma, confirmation of our findings could lead to a reappraisal of the management of elderly patients with early stage breast cancer.

Primary and secondary angiosarcoma of the breast: The Mayo Clinic experience

“…It typically occurs in women 30-50 years of age with no previous history of cancer or identifiable risk factors [1][2][3]. Recently, multiple reports have described what has been termed secondary angiosarcoma of the breast (SAS)-angiosarcoma (AS) developing in patients treated for breast cancer (BC) with breast conserving surgery (BCS) and radiation therapy (RT) [1,[3][4][5][6][7][8][9][10][11].…”

Four cases of echogenic breast lesions: a case series and review

“…(6) The incidence of post-irradiation angiosarcoma is low, ranging from 0.09% to more than 0.30%. (7)(8)(9) Our patient had an interval of eight years since her previous breast surgery and treatment. Mammographically and sonographically, the skin-thickening from the dermal lesions can be masked by postradiation skin thickening.…”

A case report of primary breast angiosarcoma causing hemorrhagic shock in pregnancy

“…The latest studies show an increase in the incidence of breast angiosarcoma due to the increased rate of breast conserving surgery and radiotherapy (5). Risk factors include trauma, radiation, lymphedema, breast implants, Xeroderma pigmentosum, neurofibromatosis and vinyl chloride (6).…”