Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer: A systematic review

Depla, Anne Louise; Scharloo-Karels, C.H.; Jong, M.A.A. de; Oldenborg, S.; Kolff, M.W.; Oei, S.B.; Coevorden, Frits van; Rhoon, Gerard C. van; Baartman, E.A.; Scholten, R. J. P. M.; Crezee, J.; Tienhoven, Geertjan van

doi:10.1016/j.ejca.2014.03.002

Cited by 123 publications

(166 citation statements)

References 77 publications

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“…In a review article of 74 case reports consisting of 222 patients of secondary chest wall and breast angiosarcoma, the authors found that surgery with radiotherapy had a better 5-year local recurrence-free interval of 57% compared to 34% for surgery alone, which, however, did not translate into survival difference [12]. Confounding factors were not adjusted in this study because information was extracted from literatures.…”

Section: Discussionmentioning

confidence: 99%

Prognosis and treatment of non-metastatic primary and secondary breast angiosarcoma: a comparative study

et al. 2017

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BackgroundBreast angiosarcoma is a rare malignancy with limited publications confined to small retrospective case reviews and case reports. Knowledge of this disease is limited because information from previous studies is insufficient and inconsistent.MethodsWe obtained data from the Surveillance, Epidemiology, and End Results Program for non-metastatic primary and secondary breast angiosarcoma, and performed analysis to determine clinicopathological characteristics and estimate their associations with overall survival (OS).ResultsMedian age was 50–54 years in primary breast angiosarcoma and 70–74 years in secondary breast angiosarcoma, while median OS was 93 and 32 months, respectively. Age, tumor grade and tumor spread were associated with poor survival outcomes. Compared with primary breast angiosarcoma, patients with secondary breast angiosarcoma had a “nominal” increased death risk (HR = 1.89, 95% CI, 1.43–2.50, p < 0.001), which was driven by older age and more aggressive tumor phenotype at presentation. Mastectomy was associated with worse OS compared with breast conservative surgery (BCS) (adjHR = 2.47, 95% CI, 1.29–4.74) in primary angiosarcoma patients. Adjuvant radiation was associated with worse OS in secondary angiosarcoma patients (adjHR =1.77, 95% CI, 1.01–3.12).ConclusionsThere is a “nominal” increased death risk in secondary breast angiosarcoma due to advanced clinicopathological features. Both BCS and mastectomy are feasible in primary and secondary angiosarcoma if R0 can be achieved. Routine radiation in unselected breast angiosarcoma should be cautious because there is no survival benefit in primary AS and appeared to be associated with a worse OS in secondary AS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3292-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Prognosis and treatment of non-metastatic primary and secondary breast angiosarcoma: a comparative study

et al. 2017

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“…However primary tumours can develop at any site, including breast, bone or viscera [1]. Secondary angiosarcoma of the breast or chest wall can be induced by chronic lymphoedema after treatment for primary breast cancer, the so-called Stewart-Treves syndrome, or maybe radiation induced, not necessarily in combination with lymphoedema [4,5]. Hepatic angiosarcomas are associated with exposure to carcinogens such as vinyl chloride, arsenic and thorium dioxide [1].…”

Section: Introductionmentioning

confidence: 99%

First-line anthracycline-based chemotherapy for angiosarcoma and other soft tissue sarcoma subtypes: Pooled analysis of eleven European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group trials

Young

Natukunda

Litière

et al. 2014

European Journal of Cancer

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“…The risk of developing breast angiosarcoma (AS) after radiation therapy (RT) for breast cancer is reported to be less than 0.5% . However, despite being a rare clinical entity, it is increasing in incidence, with improved survival of breast carcinoma patients treated with breast conservative surgery and adjuvant RT …”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes in breast angiosarcoma patients: A rare tumor with unique challenges

Gervais

Burtenshaw

Maxwell

et al. 2017

Journal of Surgical Oncology

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Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer: A systematic review

Cited by 123 publications

References 77 publications

Prognosis and treatment of non-metastatic primary and secondary breast angiosarcoma: a comparative study

Prognosis and treatment of non-metastatic primary and secondary breast angiosarcoma: a comparative study

First-line anthracycline-based chemotherapy for angiosarcoma and other soft tissue sarcoma subtypes: Pooled analysis of eleven European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group trials

Clinical outcomes in breast angiosarcoma patients: A rare tumor with unique challenges

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