Primary and secondary angiosarcomas of the breast: a single institution experience

Abstract

Angiosarcomas of the breast (ASB) are rare, representing <1% of breast malignancies. They can develop as a primary or secondary malignancy, also called post-radiation angiosarcoma. The aim of the this study is to discuss diagnosis, treatment, and outcome of primary and secondary ASB patients, diagnosed and treated in a single institution, over a 10-year period and to further compare the two conditions. We retrieved 28 consecutive cases of ASB, diagnosed from 1999 to 2009 at the European Institute of Oncology. Clinical and pathologic findings and survival analyses were performed. Of the 28 cases (27 women and 1 man), eight were primary breast angiosarcomas (PBA) and 20 were secondary breast angiosarcomas (SBA). Median follow-up was 23 months (range 1-112 months). Type of treatment (conservative or radical surgery) did not affect survival in both types of angiosarcomas. The clinical course observed was characterized by a high rate of local recurrence rather than distant metastasis or death from disease. There was a correlation between histological grade and prognosis of angiosarcomas with high-grade tumors presenting worse prognosis. SBA had a poorer prognosis compared to PBA. Our data indicate that primary and secondary ASB are distinct clinical and pathological features. SBA showed worse prognosis and was more often diagnosed in the study period compared to PBA. Physicians who care for patients who have been treated with radiation must be aware of its potential to induce angiosarcoma and stay vigilant in its detection.

Angiosarcoma and atypical vascular lesions of the breast: diagnostic and prognostic role of MYC gene amplification and protein expression

“…Our findings confirm the fact that secondary tumors have a worse prognosis when compared with primary disease, as we previously reported in a series addressing a smaller number of cases [3,26]. We also found a significant association between MYC amplification and poor prognosis in secondary angiosarcomas of the breast.…”

“…Patients with secondary AS presented with skin changes (rash and ecchymosis) with concomitant ulceration and/or bruising. Clinicopathological features from 28 cases of AS included in the present series were previously described [3]. Thirty patients were diagnosed with post-radiation AVL of the breast (Fig.…”

“…Secondary angiosarcoma (SAS) is an aggressive tumor that arises in the setting of previous irradiation field or chronic lymphedema (Stewart-Treves syndrome) and is associated with poor prognosis [1][2][3]. Atypical vascular lesions (AVL) of the breast, however, are a benign radiation-associated vascular proliferation that shows morphological similarities with low-grade secondary angiosarcomas [4][5][6][7][8][9].…”

Primary Breast Angiosarcoma: A Retrospective Study of 36 Cases from a Single Chinese Medical Institute with Clinicopathologic and Radiologic Correlations

“…Consistent with the findings of previous reports , a high rate of local recurrence (45%) rather than distant metastasis (30%) was observed in our series. Local recurrences and metastases from hematogenous dissemination were relatively common.…”

Angiosarcoma of the Breast with Solitary Metastasis to the Ovary during Pregnancy: An Uncommon Pattern of Metastatic Disease

“…It often presents following radiotherapy for breast cancer, usually after an interval of several years [2]. Primary de novo angiosarcoma of the breast is rare [3] and usually seen in relatively young women in the child bearing age group [4]. Up to half of angiosarcomas are associated with metastatic disease, either at presentation or developing subsequently [5], and several case series have shown that these tumors most often metastasize to the liver, lung, or bones [6, 7].…”