Sarcoma of the breast: breast cancer history as etiologic and prognostic factor—A population-based case–control study

Abstract

Purpose Sarcomas of the breast account for about 1% of all breast malignancies. The aim of this national survey was to explore etiologic and prognostic factors. Methods Utilizing national Swedish registers, all patients registered with mesenchymal tumors in the breast during the period 1993–2013 (n = 344) were identified and compared to up to ten age and gender matched controls. Cancer history was retrieved for cases and controls. Conditional Poisson regression models were used for calculation of odds ratios. Results Previous breast cancer was overrepresented among patients with angiosarcoma. The highest risk occurred ≥ 5 years after treatment for breast cancer (OR 73.9, 95% confidence interval, CI, 25.4–215; P < 0.001). An increase in incidence of angiosarcoma was observed during the study period (1.10, 95% CI 1.05–1.16; P < 0.001). The overall incidence of breast sarcoma increased from 1.52 to 2.04 cases per million per year. Angiosarcoma of the breast was associated with a significant excess mortality compared to age-matched controls (HR 4.65, 95% CI 3.01–7.19; P < 0.001). Conclusions Angiosarcoma increased in incidence and displayed a more severe clinical course, with significantly shorter survival. The strong association between a history of breast cancer 5 years or more prior to the diagnosis of angiosarcoma points to radiotherapy as a contributing factor.

Breast Primary Angiosarcoma: A Clinicopathologic and Imaging Study of a Series Cases

“… 2 - 5 Most of the data available in the literature on primary breast angiosarcoma come from case reports. 9 , 10 We initiated this study which reports a series of cases of primary angiosarcoma of the breast diagnosed in Togo. The objective was to study the epidemiological, clinical, diagnostic, therapeutic, and prognostic characteristics of primary angiosarcomas in the breast of our patients.…”

Radiation-associated angiosarcoma of the breast: analysis of diagnostic tools in a registry-based population

“…The incidence of radiation-associated angiosarcoma (RAASB) as a secondary malignancy after breast cancer (BC) is increasing (1--3). The primary treatment of local RAASB is radical surgery (4--6). Unfortunately, RAASB is frequently of aggressive nature and tends to progress locally if not diagnosed promptly.…”

Community Hospital Multidisciplinary Breast Conference Data Analysis - A Pathologist’s Perspective

“…The majority of angiosarcomas arise in breast of patients with a prior history of breast carcinoma occurring with a peak incidence 5-10 years after the initial diagnosis [81][82][83]. The same is true for sarcomas, and for both tumors is usually attributed to breast irradiation [81].…”

“…Breast sarcomas are rare and, excluding phyllodes tumor, are reported to comprise from less than 0.1% to 1% of all breast malignancies [33,[81][82][83][84]. The incidence of angiosarcomas is reported to be 0.04%-0.2% [33,81,84].…”

“…The majority of angiosarcomas arise in breast of patients with a prior history of breast carcinoma occurring with a peak incidence 5-10 years after the initial diagnosis [81][82][83]. The same is true for sarcomas, and for both tumors is usually attributed to breast irradiation [81]. In our study cohort, angiosarcoma and pleiomorphic sarcoma of the breast comprised 0.11% and 0.05% of all breast malignancies, respectively, and two out three occurred 11 years after ipsilateral breast carcinoma treated with irradiation.…”