Primary Angiosarcoma of the Breast—Series of 11 Consecutive Cases—A Single-Centre Experience

Kunkiel, Michał; Maczkiewicz, Marcin; Jagiełło-Gruszfeld, Agnieszka; Nowecki, Zbigniew

doi:10.3747/co.25.3816

Cited by 32 publications

(40 citation statements)

References 27 publications

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“…Majority of the previous studies on this disease have been focused exclusively [1-3, 8, 11, 14] on Western populations. Additionally, there are a limited number of analyses that have a sufficiently large cohort or an Asian perspective [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Axillary Lymph Node Dissection in Angiosarcomas of the Breast: An Asian Institutional Perspective

Ragavan

Lim

Tan

et al. 2020

Sarcoma

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Angiosarcomas of the breast (ASB) are rare, making up to less than 8% of all angiosarcomas. The surgical management for this disease continues to vary throughout centres worldwide due to the current limited evidence. We aim to examine the necessity of axillary lymph node dissection in this pathology through a retrospective study of axillary metastasis and recurrence patterns in patients treated at our institution. A retrospective review of a prospectively-maintained database was performed. All adult patients with a histologically confirmed diagnosis of ASB seen at the National Cancer Centre Singapore between 2006 and 2019 were identified. Axillary lymph node status, treatment, survival, and recurrence data were collated. Thirteen patients were identified with a confirmed diagnosis of ASB, of which there were 11 primary and 2 secondary angiosarcoma cases. Eight patients had some form of axillary lymph node dissection and 5 did not. No positive nodes were found in any examined axillary nodes despite high median number of nodes harvested (13, range 8–24). 5/13 patients had disease progression, of whom none had locoregional recurrence to the axilla. ASB continues to be rare and recurrent and presents as a challenge to treat. Axillary lymph node involvement is most likely not present in a majority of patients. Prophylactic removal is unwarranted in patients presenting without lymph node involvement due to the lack of axillary metastasis.

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Section: Discussionmentioning

confidence: 99%

Axillary Lymph Node Dissection in Angiosarcomas of the Breast: An Asian Institutional Perspective

Ragavan

Lim

Tan

et al. 2020

Sarcoma

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“…Breast angiosarcomas are extremely rare malignancies that are responsible for only 0.05% of all malignant breast tumors [ 4 ]. Knowledge of this type of malignant neoplasm is limited.…”

Section: Discussionmentioning

confidence: 99%

“…Axillary lymph node resection is not recommended due to the low rate of lymph node metastasis, however due to a possibility of lymph node metastases up to 6.1% [ 20 ], sentinel lymph node biopsy was performed in the present case. Surgery may be complemented with adjuvant radiotherapy and chemotherapy for high-grade tumors, although the efficacy of either technique is still not clear [ 4 , 5 , 9 , 11 ]. In the present case, radical surgery was performed and adjuvant chemotherapy with paclitaxel was initiated, due to the high histologic grade of the tumor and pectoralis major muscle infiltration, although some authors have shown that the schedule with doxorubicin plus ifosfamide was associated with improved of progression free survival compared to anthracycline [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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A rare case of primary breast angiosarcoma in a male: a case report

et al. 2018

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BackgroundSarcomas account for less than 1% of primary breast cancers, and breast angiosarcomas are responsible for only 0.05% of all breast malignancies. The male breast has the same potential for malignant transformation as the female breast. However, due to anatomical differences in the breast and the low incidence of angiosarcoma, it is difficult to determine how male breasts can be affected by this type of tumor.Case presentationA 36-year-old male patient was admitted to the hospital with a palpable lump in his right breast. Lymphadenopathy was negative. Ultrasonography showed a hypoechoic mass with partially defined contours, measuring 4.0 × 3.0 cm, with muscle infiltration. Histological examination revealed a malignant tumor. Radical mastectomy was then performed with clear surgical margins. The patient began chemotherapy with paclitaxel. Following the second cycle of chemotherapy, he presented with headache and seizures due to a frontal lobe metastasis. Twenty days after the onset of neurological symptoms, the patient died.ConclusionsPrimary angiosarcomas of the male breast are extremely rare. This is the sixth case published in the literature. It is in agreement with other studies in the literature concerning clinical presentation and poor prognosis. Treatment consists in surgical removal of the tumor with clear margins and without axillary lymphadenectomy.

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“…Secondary tumors are associated with chronic lymphaedema in the upper limb after axillary lymph-node dissection and radiotherapy in patients with mammary carcinoma. The condition is known as Stewart-Treves syndrome [4,8,13,14] . Secondary angiosarcoma is also considered a complication from radiotherapy and breast-conserving surgery (BCS) in patients with breast carcinoma [15] .…”

Section: Introductionmentioning

confidence: 99%

Primary angiosarcoma of the breast: A clinical case and review of the literature

2020

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We present here a rare case of primary mammary angiosarcoma in 48-year-old female patient. After 3 years without treatment, the woman presented to the hospital with locally advanced tumor in right mammary gland, involving the overlying skin and bleeding. Radical mastectomy was performed with axillary lymph-node dissection. The CT scan revealed solitary liver metastasis. After an overview of different cases of primary angiosarcoma of the breast published in the literature, we discuss the importance of histological criteria and immunohistochemical methods, as well as the optimal multimodal treatment in these patients. Poorly differentiated primary mammary angiosarcoma (grade 3) is an invasive neoplasm with high risk of local recurrence and distant metastases. The multimodal treatment involves radical mastectomy with or without axillary lymph-node dissection. Adjuvant radiotherapy and adjuvant chemotherapy help the local tumor control, reduce recurrences and increase overall survival.

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Primary Angiosarcoma of the Breast—Series of 11 Consecutive Cases—A Single-Centre Experience

Cited by 32 publications

References 27 publications

Axillary Lymph Node Dissection in Angiosarcomas of the Breast: An Asian Institutional Perspective

Axillary Lymph Node Dissection in Angiosarcomas of the Breast: An Asian Institutional Perspective

A rare case of primary breast angiosarcoma in a male: a case report

Primary angiosarcoma of the breast: A clinical case and review of the literature

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