Primary and secondary breast angiosarcoma: single center report and a meta-analysis

Abdou, Yara; Elkhanany, Ahmed; Attwood, Kristopher; Ji, Wenyan; Takabe, Kazuaki; Opyrchal, Mateusz

doi:10.1007/s10549-019-05432-4

Cited by 70 publications

(85 citation statements)

References 56 publications

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“…We found that age and tumor size were not associated with survival outcomes, which was inconsistent with previous studies. 14,15,17,30 In previous studies, researchers focused more on the relationship between age and overall survival. However, in our study, patients who died from causes other than breast angiosarcoma were considered as living.…”

Section: Discussionmentioning

confidence: 99%

“…29,36 The bene t of chemotherapy and/or radiotherapy for breast angiosarcoma is still unclear, but the side effects of these therapies are well known. On the one hand, some studies have demonstrated that chemotherapy and/or radiotherapy have bene ts in patients with breast angiosarcoma, 14,36,37 whereas several researchers reported that adjuvant therapies had no or even a negative effect on prognosis. 13,17,29 Furthermore, we found that chemotherapy and/or radiotherapy had no bene t in unselected breast angiosarcoma patients.…”

Section: Discussionmentioning

confidence: 99%

“…8 Most breast angiosarcoma patients who had other prior cancers and received radiation and/or breast resection could be classi ed as having cutaneous angiosarcomas of breast. 4,6,8,12,13 Furthermore, patients who had been diagnosed with breast cancer and received mastectomy without remaining breast parenchyma should de nitively be classi ed as having cutaneous angiosarcomas of breast 4,14 . Hence, in this study, we considered the differences between breast angiosarcoma patients without or with prior cancers.…”

Section: Introductionmentioning

confidence: 99%

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Breast Angiosarcoma: a SEER Population- Based Study

Jiang

et al. 2021

Preprint

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Background Breast angiosarcoma is a rare malignancy with poor survival. Due to the paucity of data, the generation of high-quality evidence for its high-risk features and the impact of treatment modalities on survival have been hampered. Objective To examine high-risk features and the impact of treatment modalities on disease-specific survival (DSS) in breast angiosarcoma and differences between breast angiosarcoma cases with and without other prior cancers. Methods In this retrospective study, patients with breast angiosarcoma diagnosed from 1975 to 2016 were identified from the Surveillance, Epidemiology, and End Results database. Cox proportional hazards regression analysis adjusted for age, race, decade at diagnosis, location, pathologic grade, extent of disease, tumor size, and therapy to model DSS outcomes. Propensity score matching analyses were performed to adjust for the differences between breast angiosarcoma cases with and without other prior cancers to compare their DSS values. A Kaplan-Meier curve was used to visualize the cumulative survival probability. Results Of 648 patients with breast angiosarcoma, 55.4% had a prior cancer diagnosis. Older (age ≥ 70) patients were more likely to have breast angiosarcoma with prior cancer than younger patients (64.3% versus 21.8%). Via multivariate analysis, pathologic grade and extent of disease were identified to be significantly associated with DSS in breast angiosarcoma. In matched data, breast angiosarcoma patients with prior cancer had a better DSS than those without prior cancer (HR = 0.60, 95%CI 0.38–0.96, p = 0.0389). In breast angiosarcoma patients without prior cancer, patients with larger tumor size receiving surgery plus radiation or/and chemotherapy might have a better survival than those patients receiving surgery only (HR = 0.38, 95%CI 0.14–0.99, p = 0.0128). DSS is not impacted by the current therapeutic strategies in unselected breast angiosarcoma patients. Conclusions Breast angiosarcoma patients with prior cancer have a better DSS than those without prior cancer. Additionally, some breast angiosarcoma cases with prior cancer may be cutaneous angiosarcomas. Pathologic grade and extent disease are high-risk features. DSS is not impacted by the current therapeutic strategies in unselected breast angiosarcoma patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Breast Angiosarcoma: a SEER Population- Based Study

Jiang

et al. 2021

Preprint

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“…It arises de novo and is usually seen in young women between 30 and 50 years of age. 2 The tumor originates in the stromal tissue of the breast parenchyma with rare involvement of the skin.…”

Section: Introductionmentioning

confidence: 99%

Secondary Angiosarcoma With C-MYC Amplification Following Prophylactic Bilateral Mastectomy and Autologous Breast Reconstruction: Report of a Case and Review of the Literature

et al. 2020

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In this article, we report a very rare case of secondary angiosarcoma in a young woman with no prior history of breast cancer who had bilateral prophylactic mastectomies with autologous reconstruction due to a strong family history of breast cancer and BRCA1 gene variant of uncertain significance. The surgery was complicated by recurrent fat necrosis requiring several excisions and additional reconstruction followed by the development of localized lymphedema and subsequent angiosarcoma in the reconstructed breast 10 years later. The angiosarcoma was high grade with prominent epithelioid features associated with abundant tumor-infiltrating lymphocytes. Amplification of C-MYC locus 8q21.24 was demonstrated by fluorescence in situ hybridization study. We postulate that chronic trauma from several surgeries including tissue hypoxia and impaired lymphatic drainage may have provided a milieu for angiogenesis and mutagenic transformation. Amplification of C-MYC locus 8q21.24 was most likely a strong oncogenic driver of angiosarcoma. To the best of our knowledge, this is the first report of its kind in the literature.

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“…We have read with great interest the article "Primary and secondary breast angiosarcoma: single center report and a meta-analysis" published by Abdou et al [1]. Firstly, we would like to congratulate the authors on this comprehensive article and huge experience.…”

Section: Introductionmentioning

confidence: 99%