Angiosarcoma after conservation treatment for breast carcinoma: Our experience and a review of the literature

J. Fodor, Zsolt Orosz, Éva Szabó, Z. Sulyok, C. Polgár, Zoltán Zaka, T. Major

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

The development of angiosarcoma of the breast is a recognized complication of breast conservation therapy (BCT), but the evolution, prevalence, and outcome have not been accurately established. We sought to evaluate and review the clinicopathologic, prognostic, and treatment attributes of angiosarcoma arising in the irradiated breast after BCT. We conducted a retrospective chart and slide review of 8 patients seen between 1996 and 2004 with a diagnosis of secondary angiosarcoma. All were treated with mastectomy. Clinical and histopathologic findings were studied and previously reported cases were reviewed. Primary surgery-related breast edema and cellulitis was observed in 7 and 5 patients of the 8 patients studied, respectively. Postirradiation breast edema and grade 2/3 fibrosis occurred in 5 and 8 patients, respectively. The mean age of the patients at onset of the breast cancer and angiosarcoma was 65 and 72 years, respectively. The mean latency period between the treatment of the breast cancer and the diagnosis of angiosarcoma was 75 months. The actuarial rate of 2-year survival for patients presented with single (n = 4) compared with multiple (n = 4) skin lesions was 50% and 0%, respectively (P = .0233). The estimated incidence of angiosarcoma after BCT was found to be 0.14 %. BCT-associated angiosarcoma arises after a relatively brief interval, and breast edema-fibrosis can possibly contribute to its development. Special attention should be paid to skin changes occurring after BCT. The extent of skin lesions is predictive of survival. As shown by a review of the literature, angiosarcomas are often resistant to surgery, chemotherapy, and radiotherapy, and targeted therapy against tumor biological properties may be a new approach to angiosarcoma treatment.

Original languageEnglish
Pages (from-to)499-504
Number of pages6
JournalJournal of the American Academy of Dermatology
Volume54
Issue number3
DOIs
Publication statusPublished - Mar 2006

Fingerprint

Hemangiosarcoma
Segmental Mastectomy
Breast Neoplasms
Breast
Edema
Skin
Fibrosis
Therapeutics
Cellulitis
Survival
Mastectomy
Age of Onset
Radiotherapy
Drug Therapy
Incidence
Angiosarcoma of the breast
Neoplasms

ASJC Scopus subject areas

  • Dermatology

Cite this

Angiosarcoma after conservation treatment for breast carcinoma : Our experience and a review of the literature. / Fodor, J.; Orosz, Zsolt; Szabó, Éva; Sulyok, Z.; Polgár, C.; Zaka, Zoltán; Major, T.

In: Journal of the American Academy of Dermatology, Vol. 54, No. 3, 03.2006, p. 499-504.

Research output: Contribution to journalArticle

@article{5bc8325ca67c448098690a2f11b0b5a3,
title = "Angiosarcoma after conservation treatment for breast carcinoma: Our experience and a review of the literature",
abstract = "The development of angiosarcoma of the breast is a recognized complication of breast conservation therapy (BCT), but the evolution, prevalence, and outcome have not been accurately established. We sought to evaluate and review the clinicopathologic, prognostic, and treatment attributes of angiosarcoma arising in the irradiated breast after BCT. We conducted a retrospective chart and slide review of 8 patients seen between 1996 and 2004 with a diagnosis of secondary angiosarcoma. All were treated with mastectomy. Clinical and histopathologic findings were studied and previously reported cases were reviewed. Primary surgery-related breast edema and cellulitis was observed in 7 and 5 patients of the 8 patients studied, respectively. Postirradiation breast edema and grade 2/3 fibrosis occurred in 5 and 8 patients, respectively. The mean age of the patients at onset of the breast cancer and angiosarcoma was 65 and 72 years, respectively. The mean latency period between the treatment of the breast cancer and the diagnosis of angiosarcoma was 75 months. The actuarial rate of 2-year survival for patients presented with single (n = 4) compared with multiple (n = 4) skin lesions was 50{\%} and 0{\%}, respectively (P = .0233). The estimated incidence of angiosarcoma after BCT was found to be 0.14 {\%}. BCT-associated angiosarcoma arises after a relatively brief interval, and breast edema-fibrosis can possibly contribute to its development. Special attention should be paid to skin changes occurring after BCT. The extent of skin lesions is predictive of survival. As shown by a review of the literature, angiosarcomas are often resistant to surgery, chemotherapy, and radiotherapy, and targeted therapy against tumor biological properties may be a new approach to angiosarcoma treatment.",
author = "J. Fodor and Zsolt Orosz and {\'E}va Szab{\'o} and Z. Sulyok and C. Polg{\'a}r and Zolt{\'a}n Zaka and T. Major",
year = "2006",
month = "3",
doi = "10.1016/j.jaad.2005.10.017",
language = "English",
volume = "54",
pages = "499--504",
journal = "Journal of the American Academy of Dermatology",
issn = "0190-9622",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Angiosarcoma after conservation treatment for breast carcinoma

T2 - Our experience and a review of the literature

AU - Fodor, J.

AU - Orosz, Zsolt

AU - Szabó, Éva

AU - Sulyok, Z.

AU - Polgár, C.

AU - Zaka, Zoltán

AU - Major, T.

PY - 2006/3

Y1 - 2006/3

N2 - The development of angiosarcoma of the breast is a recognized complication of breast conservation therapy (BCT), but the evolution, prevalence, and outcome have not been accurately established. We sought to evaluate and review the clinicopathologic, prognostic, and treatment attributes of angiosarcoma arising in the irradiated breast after BCT. We conducted a retrospective chart and slide review of 8 patients seen between 1996 and 2004 with a diagnosis of secondary angiosarcoma. All were treated with mastectomy. Clinical and histopathologic findings were studied and previously reported cases were reviewed. Primary surgery-related breast edema and cellulitis was observed in 7 and 5 patients of the 8 patients studied, respectively. Postirradiation breast edema and grade 2/3 fibrosis occurred in 5 and 8 patients, respectively. The mean age of the patients at onset of the breast cancer and angiosarcoma was 65 and 72 years, respectively. The mean latency period between the treatment of the breast cancer and the diagnosis of angiosarcoma was 75 months. The actuarial rate of 2-year survival for patients presented with single (n = 4) compared with multiple (n = 4) skin lesions was 50% and 0%, respectively (P = .0233). The estimated incidence of angiosarcoma after BCT was found to be 0.14 %. BCT-associated angiosarcoma arises after a relatively brief interval, and breast edema-fibrosis can possibly contribute to its development. Special attention should be paid to skin changes occurring after BCT. The extent of skin lesions is predictive of survival. As shown by a review of the literature, angiosarcomas are often resistant to surgery, chemotherapy, and radiotherapy, and targeted therapy against tumor biological properties may be a new approach to angiosarcoma treatment.

AB - The development of angiosarcoma of the breast is a recognized complication of breast conservation therapy (BCT), but the evolution, prevalence, and outcome have not been accurately established. We sought to evaluate and review the clinicopathologic, prognostic, and treatment attributes of angiosarcoma arising in the irradiated breast after BCT. We conducted a retrospective chart and slide review of 8 patients seen between 1996 and 2004 with a diagnosis of secondary angiosarcoma. All were treated with mastectomy. Clinical and histopathologic findings were studied and previously reported cases were reviewed. Primary surgery-related breast edema and cellulitis was observed in 7 and 5 patients of the 8 patients studied, respectively. Postirradiation breast edema and grade 2/3 fibrosis occurred in 5 and 8 patients, respectively. The mean age of the patients at onset of the breast cancer and angiosarcoma was 65 and 72 years, respectively. The mean latency period between the treatment of the breast cancer and the diagnosis of angiosarcoma was 75 months. The actuarial rate of 2-year survival for patients presented with single (n = 4) compared with multiple (n = 4) skin lesions was 50% and 0%, respectively (P = .0233). The estimated incidence of angiosarcoma after BCT was found to be 0.14 %. BCT-associated angiosarcoma arises after a relatively brief interval, and breast edema-fibrosis can possibly contribute to its development. Special attention should be paid to skin changes occurring after BCT. The extent of skin lesions is predictive of survival. As shown by a review of the literature, angiosarcomas are often resistant to surgery, chemotherapy, and radiotherapy, and targeted therapy against tumor biological properties may be a new approach to angiosarcoma treatment.

UR - http://www.scopus.com/inward/record.url?scp=32644443465&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=32644443465&partnerID=8YFLogxK

U2 - 10.1016/j.jaad.2005.10.017

DO - 10.1016/j.jaad.2005.10.017

M3 - Article

C2 - 16488303

AN - SCOPUS:32644443465

VL - 54

SP - 499

EP - 504

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

SN - 0190-9622

IS - 3

ER -