Angiosarcoma After Breast Radiation — Risk is Low, but Real Angiosarcoma After Breast Radiation — Risk is Low, but Real

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The risk of developing angiosarcoma following radiotherapy for breast cancer is low but present, and it should be treated at least with surgery, say Dutch researchers in the largest study to date.Medscape Medical News

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A 72-year-old woman presented with 2-month history of “bruises” on the left breast. She was treated for a left breast cancer 6 years earlier. She previously had stage IA (cT1cN0M0) invasive ductal carcinoma that was estrogen receptor/progesterone receptor positive and Her2 negative. She underwent partial mastectomy and sentinel lymph node biopsy th at confirmed stage pT1cN0. In the setting of bilateral silicone breast implants, she received adjuvant partial breast irradiation to 36 Gy in 9 fractions twice daily, targeting the seroma with 1.5 to 2 cm margins.

This is a short clinical report depicting an exceptionally early presentation of radiation-induced angiosarcoma and overview of the literature. This case highlights the need for a high level of clinical suspicion in those patients presenting with unresolving cutaneous skin changes after radiotherapy for breast cancer.
Breast-conserving therapy, comprising breast-conserving surgery and adjuvant radiotherapy, has largely replaced mastectomy in the treatment of early-stage breast carcinoma. Breast angiosarcoma is a rare but severe long-term complication associated with postoperative radiotherapy (Int J Radiat Oncol Biol Phys…

ConclusionThe preferred treatment is always aggressive surgical removal and, as our atypical clinical case suggests, neoadjuvant chemotherapy in very high doses is also needed. A biopsy of any suspicious breast skin lesion after radiotherapy is recommended. Despite the treatment challenges, our case provides enlightening details on the management of such a rare cancer even when faced with unplanned events which do not always allow for a textbook approach.

We present the case of a 52-year-old female who had undergone mastectomy due to breast cancer and 13 years later required shoulder disarticulation due to Stewart-Treves syndrome.
PMID: 30838096 [PubMed]

Source: Oman Medical JournalCategory: Middle East Health Tags: Oman Med J Source Type: research

CONCLUSIONS: Secondary breast angiosarcoma is a very aggressive disease associated with a short survival outcome. The surgical approach still remains an important step in the course of treatment; furthermore, an accurate histological examination is helpful in establishing the prognosis of the patient. A mastectomy is mandatory. A longer OS was observed in patients with low-grade angiosarcoma as compared to high-grade angiosarcoma (C.I. 40-57 vs. 31-41 months).
PMID: 30877870 [PubMed – as supplied by publisher]

Source: BreastCategory: Cancer & Oncology Authors: Tags: Breast Source Type: research

ConclusionsThe extent of surgery is not associated with improved survival in women with LBA, and patients may consider breast-conservation surgery. Adjuvant therapies are not associated with improved survival, with the exception of possible role of adjuvant chemotherapy in large primary tumors (5  cm or greater). Further clinical studies are needed to determine the impact of these treatments on local control, progression-free survival, and patients’ quality of life. Until then, the findings of our analysis will form basis for the multi-disciplinary discussion of management of women with L BA.

CONCLUSION: Angiosarcoma in lympedematous upper limbs or after breast cancer irradiation remains uncommon. However, its long latency and high mortality warrant long-term vigilant surveillance.
PMID: 30738715 [PubMed – as supplied by publisher]

Source: Clinical Genitourinary CancerCategory: Cancer & Oncology Authors: Tags: Clin Oncol (R Coll Radiol) Source Type: research

Secondary angiosarcoma is known to be associated with lymphoedema or radiation after cancer treatment. This systematic review aims to evaluate the clinical features and outcomes of secondary angiosarcoma commonly arising after breast cancer treatment.

Source: Clinical OncologyCategory: Radiology Authors: Tags: Original Article Source Type: research

Abstract Sarcomas of the breast belong to a heterogeneous group of breast tumors of mesenchymal origin, without epithelial components. These tumors can be primary or secondary (after previous treatment for breast cancer), are rare, present aggressive behavior, and have a poor prognosis. They occur mainly in women between 45 and 50 years of age, with the exception of angiosarcomas, which can occur in younger patients. Clinically, breast sarcomas manifest as palpable, mobile, rapidly growing masses, without skin thickening, axillary lymphadenopathy, or nipple discharge. Although the imaging findings are non specific, they ca…

Abstract Sarcomas of the breast belong to a heterogeneous group of breast tumors of mesenchymal origin, without epithelial components. These tumors can be primary or secondary (after previous treatment for breast cancer), are rare, present aggressive behavior, and have a poor prognosis. They occur mainly in women between 45 and 50 years of age, with the exception of angiosarcomas, which can occur in younger patients. Clinically, breast sarcomas manifest as palpable, mobile, rapidly growing masses, without skin thickening, axillary lymphadenopathy, or nipple discharge. Although the imaging findings are non specific, they ca…

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