Post‐radiotherapy vascular lesions of the breast: immunohistochemical and molecular features of 74 cases with long‐term follow‐up and literature review

Corradini, Alessandra; Asioli, Sofia; Morandi, Luca; Brotto, Maurizio; Righi, Alberto; Iommi, Marica; Agostinelli, Claudio; Rucci, Paola; Asioli, Silvia; Sapino, Anna; Viale, Giuseppe; Foschini, Maria Pia

doi:10.1111/his.14090

Cited by 12 publications

(12 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Grading of RT-AS is controversial and not consistently reported, given the discrepant results regarding its prognostic value. 9,[22][23][24] Recently, two studies have shown that histological grade 3 RT-ASs of the breast are associated with worse OS and DFS than grade 1 or 2 tumours. 9,23 In a study of 176 radiation sarcomas (including 67 RT-ASs of the breast), Mito et al found that high-grade tumours were associated with worse OS.…”

Section: Discussionmentioning

confidence: 99%

“…9,[22][23][24] Recently, two studies have shown that histological grade 3 RT-ASs of the breast are associated with worse OS and DFS than grade 1 or 2 tumours. 9,23 In a study of 176 radiation sarcomas (including 67 RT-ASs of the breast), Mito et al found that high-grade tumours were associated with worse OS. 25 On the basis of these findings, reporting the histological grade of RT-AS is recommended, as it may have prognostic significance.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of MYC gene amplification on the clinicopathological features and prognosis of radiation‐associated angiosarcomas of the breast

Kuba

D’Angelo

et al. 2021

Histopathology

View full text Add to dashboard Cite

The impact of MYC amplification on the clinicopathological features and prognosis of radiation-associated angiosarcomas of the breast Aims: Radiation-associated angiosarcomas (RT-ASs) of the breast are rare tumours with a poor prognosis. MYC gene amplification is considered to be the hallmark of RT-AS, and is sometimes used as a diagnostic tool to distinguish it from other radiation-associated vascular lesions. However, a small subset of RT-ASs lacks MYC amplification, and this may be associated with better outcome. Loss of trimethylation at lysine 27 of histone 3 (H3K27me3) expression by immunohistochemistry (IHC) has been recently postulated as an additional diagnostic marker for RT-AS. The aims of this study were to evaluate the impact of MYC amplification as detected by fluorescence in-situ hybridisation and/or next-gen eration sequencing on clinicopathological features and outcome in a large cohort of RT-ASs, compare outcome with those of radiation-associated sarcomas (RT-Ss) of the breast other than angiosarcoma, and evaluate expression of H3K27me3 IHC in these groups.Methods and results: Eighty-one RT-ASs were identified, including 73 that were MYC-amplified and 8 (10%) that were MYC-non-amplified. MYC-amplified RT-ASs were diagnosed in older patients (median age, 69 years versus 61 years). The 5-year disease-specific survival and 5-year overall survival rates were 56% and 47%, respectively. Older age, larger tumour size, positive margin and MYC amplification were associated with worse prognosis. None of the RT-ASs showed complete loss of H3K27me3 IHC expression. All 18 RT-Ss were MYC-non-amplified, and complete loss of H3K27me3 expression was seen in 2 cases. We found no difference in prognosis between RT-AS and RT-S. Conclusions: RT-AS of the breast is associated with a poor prognosis. Older age at diagnosis, larger tumour size, positive margin at excision and MYC amplification are associated with worse prognosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impact of MYC gene amplification on the clinicopathological features and prognosis of radiation‐associated angiosarcomas of the breast

Kuba

D’Angelo

et al. 2021

Histopathology

View full text Add to dashboard Cite

show abstract

“…Studies of primary and secondary angiosarcomas have found conflicting results on the prognostic significance of tumor size and margin status. 4,5,14,17,[21][22][23][24][25] Similarly, other studies have not found a predictive value in adjuvant/neoadjuvant therapy. 2,21 It should be noted that histologic grading should be reserved for excision specimens.…”

Section: Discussionmentioning

confidence: 99%

Histopathologic Grading Is of Prognostic Significance in Primary Angiosarcoma of Breast

Kuba¹,

Dermawan²,

Xu³

et al. 2022

American Journal of Surgical Pathology

View full text Add to dashboard Cite

Despite a wide spectrum of clinical presentations, including primary or secondary, most angiosarcomas are considered high grade. One exception is primary breast angiosarcoma, where historically, histologic grading has shown to predict outcome using the Rosen 3-tier system. However, more recent studies have challenged this concept suggesting that even in this specific clinical context angiosarcomas should be considered high grade. This study aimed to critically reevaluate the impact of histologic grade in a clinically uniform cohort managed at a single institution using a newly proposed grading system. Our study included 49 primary breast angiosarcomas diagnosed during 1994 to 2022 (median follow-up: 33 mo), classified as low grade (29%), intermediate grade (20%), and high grade (51%), based on mitotic count, extent of solid components, and necrosis. At last follow-up, 22% patients developed locoregional recurrences, 63% distant metastases, and 47% patients died of disease. As patients with low and intermediate-grade angiosarcomas had relatively similar outcomes, our cohort was further analyzed using a 2-tier system (low grade and high grade). Targeted-DNA next-generation sequencing (505 cancer gene panel) performed in 11 cases found KDR mutations in 78% and PIK3CA mutations in 44% of high-grade lesions. Histologic grade, by either 3-tier or 2-tier grading systems, had a strong impact on survival, with the 2-tier system being an independent predictor of disease-specific survival and overall survival. Based on 2-tier system, the 5-year overall survival was 38% for high-grade angiosarcoma and 74% for low-grade angiosarcoma. PIK3CA mutations alone or concurrent with KDR alterations were identified in angiosarcomas with worse prognosis.

show abstract

“…112 Majority of PTEN mutation reported to the AS Project were putative drivers, including truncating and missense mutations, with only one patient harbouring missense mutation of unknown significance 113 (detailed explanation in Figures 2 and 3). Corradini et al 114 identified PTEN mutants in 50% in radiotherapy-induced ASs. 114 Studies showed that AS has weak PTEN immunoreactivity, 115 and in high-grade tumours PTEN expression was largely absent.…”

Section: Alterations Of Intracellular Signalling Pathways and Importa...mentioning

confidence: 99%

New molecular targets in canine hemangiosarcoma—Comparative review and future of the precision medicine

Kapturska

Pawlak

2023

Vet Comparative Oncology

View full text Add to dashboard Cite

Human angiosarcoma and canine hemangiosarcoma reveal similarities not only in their aggressive clinical behaviour, but especially in molecular landscape and genetic alterations involved in tumorigenesis and metastasis formation. Currently, no satisfying treatment that allows for achieving long overall survival or even prolonged time to progression does not exist. Due to the progress that has been made in targeted therapies and precision medicine the basis for a new treatment design is to uncover mutations and their functions as possible targets to provide tailored drugs for individual cases. Whole exome or genome sequencing studies and immunohistochemistry brought in the last few years important discoveries and identified the most common mutations with probably crucial role in this tumour development. Also, despite a lack of mutation in some of the culprit genes, the cancerogenesis cause may be buried in main cellular pathways connected with proteins encoded by those genes and involving, for example, pathological angiogenesis. The aim of this review is to highlight the most promising molecular targets for precision oncology treatment from the veterinary perspective aided by the principles of comparative science. Some of the drugs are only undergoing laboratory in vitro studies and others entered the clinic in the management of other cancer types in humans, but those used in dogs with promising responses have been mentioned as priorities.

show abstract

Post‐radiotherapy vascular lesions of the breast: immunohistochemical and molecular features of 74 cases with long‐term follow‐up and literature review

Cited by 12 publications

References 17 publications

The impact of MYC gene amplification on the clinicopathological features and prognosis of radiation‐associated angiosarcomas of the breast

The impact of MYC gene amplification on the clinicopathological features and prognosis of radiation‐associated angiosarcomas of the breast

Histopathologic Grading Is of Prognostic Significance in Primary Angiosarcoma of Breast

New molecular targets in canine hemangiosarcoma—Comparative review and future of the precision medicine

Contact Info

Product

Resources

About