Clinical management of secondary angiosarcoma after breast conservation therapy

Abstract

Angiosarcoma remains a difficult management problem with poor loco-regional and distal control. In our study, an overall incidence rate of secondary breast angiosarcoma is 0.065%. Although the prognosis for this disease is poor (typical survival period is 14.5-34 months with a 5-year survival rate of approximately 15%), all the three patients treated at our institute are alive and disease-free at the end of reported period. Finally, it is assumed that the use of breast conserving therapy will increase the incidence of post-irradiation angiosarcoma but the small difference in risk of subsequent sarcoma of the breast cancer patients receiving radiotherapy does not suppress its benefit.

Low dose out-of-field radiotherapy, part 1: Measurement of scattered doses

“…Thus, total uncertainty of dose determination, as calculated using the total differential method, was 6-8% (photons) and 6-9% (neutrons), depending on position of the dosimetric point (Figs. [3][4][5].…”

“…Although such technologies are more precise than three-dimensional conformal radiotherapy, and appear to increase survival rates through better tumour coverage and sparing of adjacent healthy tissue, the high doses of radiation delivered by these techniques may lead to long-term adverse effects -primarily second cancers -as a consequence of the significantly larger out-of-field doses [1][2][3][4][5]. These out-of-field doses are commonly attributable to scattered radiation from the accelerator head, treatment room (the floor, walls, ceiling), the patient's own body, and/or leakage through the collimator [6].…”

Breast angiosarcoma: A case report

“…For locally advanced inoperable or metastatic disease, chemotherapy is the pillar of treatment [17].…”

Double-edged sword of radiotherapy: a cause of secondary angiosarcoma after breast conservation therapy

“…Angiosarcomas can originate in a variety of places (liver, spleen, bone or heart), and approximately 8% arise in the breast 2 3. Indeed, they account for 0.04% of malignant neoplasms of the breast and have a poor long-term prognosis 4…”