Secondary breast angiosarcoma: A multicentre retrospective survey by the national Italian association of Breast Surgeons (ANISC)

Taffurelli, Mario; Pellegrini, Antonio; Meattini, Icro; Orzalesi, Lorenzo; Tinterri, Corrado; Roncella, Manuela; Terribile, Daniela; Caruso, Francesco; Tazzioli, Giovanni; Pollini, Giovanni Paolo; Friedman, Daniele; Mariotti, Carlo; Cianchetti, Ettore; Cabula, Carlo; Thomas, R.; Cedolini, Carla; Rovera, Francesca; Grassi, M.; Lucani, G; Cappella, Annalisa; Bortul, Marina; Stacul, G.; Scarabeo, F.; Procaccini, E; Galimberti, Viviana

doi:10.1016/j.breast.2019.02.011

Cited by 21 publications

(19 citation statements)

References 13 publications

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“…Radiation-induced breast angiosarcoma has also been associated with a worse prognosis than primary angiosarcoma [ 32 – 34 ]. Based on a recent survey from Italy, including 112 patients treated at 24 centers, only 50.5% of the patients were still alive after 5 years follow-up, and the disease-free survival was only 35 months [ 32 ]. In our cohort, no such difference was obvious, possibly due to the limited size of the cohort.…”

Section: Discussionmentioning

confidence: 99%

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

Karlsson

Granath

Smedby

et al. 2020

Breast Cancer Res Treat

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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.

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Section: Discussionmentioning

confidence: 99%

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

Karlsson

Granath

Smedby

et al. 2020

Breast Cancer Res Treat

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“…Secondary angiosarcoma presents an average of 6 years after previous radiotherapy treatment, which coincides with the presentation of our second case, a 71-year-old patient with breast angiosarcoma secondary to radiotherapy treatment, which was treated with surgery of rescue and a disease-free survival of 38 months, similar to the series by Taffurelli et al that analysed the presentation of 24 cases of secondary angiosarcoma of the breast, presenting a new local recurrence in the chest wall, again requiring resection with free margins, achieving so far an overall survival of 49 months and disease-free survival after the last treatment of 11 months [19]. As shown in the cases presented and in relation to what is described in the literature, the treatment that has shown the best results in primary or secondary breast angiosarcoma despite its poor prognosis continues to be surgical resection with free margins, either in the first instance or rescue.…”

Section: Discussionmentioning

confidence: 62%

Primary and Secondary Angiosarcoma of the Breast: Report of Two Cases and Review of the Literature

Rivas-Mendoza¹,

Calixto-Martínez²,

Valencia-Cedillo³

et al. 2021

RCO

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Introduction: The breast's angiosarcoma is a rare entity, representing 1% of the breast's malignant neoplasms and is classified as primary and secondary; the latter is associated with radiotherapy and chronic lymphedema. Clinically both present as a voluminous and rapidly growing lesion. Surgery is the cornerstone of a treatment since it provides the most outstanding local control, whereas radiotherapy and chemotherapy have little impact on the disease. Similarly, the oncological prognosis is poor because this type of tumor has a high recurrence rate and overall, 5-year survival of only 20%. Objective: Two cases of angiosarcoma of the breast (primary and secondary) are reported, both treated in the Breast Tumor Service and a bibliographic review of the disease is presented. Materials and Methods: All breast cancer cases were reviewed in the Breast Tumor Service for two years. Results: In the first clinical case, a 61-year-old patient was presented with a 5-month-old primary angiosarcoma in the right breast, treated with modified radical mastectomy. While in the second case, the clinical history of a 76-year-old woman with secondary breast angiosarcoma is related; the patient had a history of right breast cancer, treated ten years previously with conservative surgery, sentinel node and adjuvant radiotherapy. However, the woman presented local recurrence six years later, and she was operated on with a total mastectomy. Three years later, she developed an angiosarcoma in the surgical bed that warranted a wide resection of the chest wall. Conclusion: The breast's angiosarcoma is an aggressive and rare tumor of unknown aetiology, since it has a high recurrence rate and poor survival. Its main prognostic factors are tumor volume and resection margins. Therefore, early diagnosis is essential because it allows complete resection of the lesion.

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“…Authors concluded that there were no statistically significant outcomes concerning recurrence-free survival or overall survival comparing mastectomy to BCS. In our opinion, BCS should be considered only in patients with breast angiosarcoma with small size tumors [2]. Besides, BCS is a rather challenging approach in the combination of big tumors and small-or medium-sized breasts.…”

Section: Introductionmentioning

confidence: 96%

Proper treatment of breast angiosarcoma-mastectomy or breast conserving surgery?

Zdravkovic

Granić

Crnokrak

2019

Breast Cancer Res Treat

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Secondary breast angiosarcoma: A multicentre retrospective survey by the national Italian association of Breast Surgeons (ANISC)

Cited by 21 publications

References 13 publications

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

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

Primary and Secondary Angiosarcoma of the Breast: Report of Two Cases and Review of the Literature

Proper treatment of breast angiosarcoma-mastectomy or breast conserving surgery?

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