Skip to main content

Advertisement

Log in

Breast angiosarcoma that is not related to radiation exposure: A comprehensive review of the literature

  • Review Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Breast angiosarcomas that are not related to previous radiotherapy are very rare. Surgical resection is the primary treatment for these tumors, but there is no general agreement on the extent of surgery. The role of multimodality adjuvant treatment also remains controversial. The aim of this study was to summarize the available data from the largest published series of patients in terms of management and outcome. We also sought to identify prognostic factors influencing patient survival. We have included studies presenting detailed data on multimodality therapy and survival of patients with breast angiosarcoma. Ten studies presenting data on 280 patients were included in the review. Seventyfive percent of patients underwent a total mastectomy and 25% had breast-conserving treatment (BCT). In 42% of patients, an axillary node dissection was combined with mastectomy or BCT. Thirty-six percent of patients received chemotherapy and 35% were treated with radiotherapy in an adjuvant or neoadjuvant setting. Survival varied significantly according to tumor size and grade. Adjuvant multimodality therapy may improve the outcome in selected patients with breast angiosarcoma. Tumor size, grade, and margin status are the most important prognostic factors for survival.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Monroe AT, Feigenberg SJ, Mendenhall NP. Angiosarcoma after breast-conserving therapy. Cancer 2003;97:1832–1840.

    Article  PubMed  Google Scholar 

  2. Borrman R. Metastasenbildung bei Histologish Gutartigen Geschwulsten: Fall von Metastasierendem Angiom. Beitr Pathol Anat 1907;40:372–393.

    Google Scholar 

  3. Donnell RM, Rosen PP, Lieberman PH, Kaufman RJ, Kay S, Braun DW Jr, et al. Angiosarcoma and other vascular tumors of the breast. Pathologic analysis as a guide to prognosis. Am J Surg Pathol 1981;5:629–642.

    Article  CAS  PubMed  Google Scholar 

  4. Britt LD, Lambert P, Sharma R, Ladaga LE. Angiosarcoma of the breast. Initial misdiagnosis is still common. Arch Surg 1995;130:221–223.

    CAS  PubMed  Google Scholar 

  5. Moore MP, Kinne DW. Breast sarcoma. Surg Clin North Am 1996;76:383–392.

    Article  CAS  PubMed  Google Scholar 

  6. Bernathova M, Janchke W, Pechlahner C, Zelger B, Bodner G. Primary angiosarcoma of the breast associated Kasabach-Merritt syndrome during pregnancy. Breast 2006;15:255–258.

    Article  PubMed  Google Scholar 

  7. Moussa SHY, Oliveira ALK, de Amorim AP, Zelger B, Bodner G. Angiosarcoma of the breast associated with Kasabach-Merritt syndrome. Arch Gynecol Obstet 2002;267:43–45.

    Article  CAS  PubMed  Google Scholar 

  8. Glazebrook KN, Magut MJ, Reynolds C. Angiosarcoma of the breast. Am J Radiol 2008;190:533–538.

    Google Scholar 

  9. Yang WT, Hennessy BTJ, Dryden MJ, Valero V, Hunt KK, Krishnamurthy S. Mammary angiosarcomas: Imaging findings in 24 patients. Radiology 2007;242:725–734.

    Article  PubMed  Google Scholar 

  10. Gherardi G, Rossi S, Perrone S, Scanni A. Angiosarcoma after breast-conserving therapy: fine needle aspiration biopsy, immunohistochemistry and clinicopathologic correlates. Cancer 2005;105:145–151.

    Article  PubMed  Google Scholar 

  11. Mazeron JJ, Suit HD. Lymph nodes as sites of metastasis from sarcomas of soft tissue. Cancer 1987;60:1800–1808.

    Article  CAS  PubMed  Google Scholar 

  12. Rosen PP, Kimel M, Ernsberger D. Mammary angiosarcoma. The prognostic significance of tumor differentiation. Cancer 1988;62:2145–2151.

    Article  CAS  PubMed  Google Scholar 

  13. Bousquet G, Confavreux C, Magne N, de Lara CT, Poortmans P, Senkus E, et al. Outcome and prognostic factors in breast sarcoma: a multicenter study from the rare cancer network. Radiother Oncol 2007;85:355–361.

    Article  PubMed  Google Scholar 

  14. Confavreux C, Lurkin A, Mitton N, Blondet R, Saba C, Ranchère D, et al. Sarcomas and malignant phyllodes tumours of the breast — a retrospective study. Eur J Cancer 2006;42:2715–2721.

    Article  CAS  PubMed  Google Scholar 

  15. Blanchard DK, Reynolds CA, Grant CS, Donohue JH. Primary nonphyloides breast sarcomas. Am J Surg 2003;186:359–361.

    Article  PubMed  Google Scholar 

  16. Gullet NP, Delman K, Folpe AL, Johnstone PA. National surgical patterns of care. Regional lymphadenectomy of breast sarcomas. Am J Clin Oncol 2007;30:461–465.

    Article  Google Scholar 

  17. Delaney TF, Yang JC, Glatstein E. Adjuvant therapy for adult patients with soft tissue sarcomas. Oncology (Willinston Park) 1991;5:105–118.

    CAS  Google Scholar 

  18. Tierney JF, Mosseri V, Stewart LA, Souhami RL, Parmar MK. Adjuvant chemotherapy for soft-tissue sarcoma: review and metaanalysis of the published results of randomized clinical trials. Br J Cancer 1995;72:469–475.

    Article  CAS  PubMed  Google Scholar 

  19. Pervaiz N, Colterjohn N, Farrokkhyar F, Tozer R, Figueredo A, Ghert M. A systematic meta-analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable softtissue sarcoma. Cancer 2008;113:573–581.

    Article  PubMed  Google Scholar 

  20. Frustaci S, Gherlinzoni F, De Paoli A, Bonetti M, Azzarelli A, Comandone A, et al. Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: results of the Italian randomized cooperative trial. J Clin Oncol 2001;19:1238–1247.

    CAS  PubMed  Google Scholar 

  21. Sher T, Hennessy BT, Valero V, Broglio K, Woodward WA, Trent J, et al. Primary angiosarcomas of the breast. Cancer 2007;110:173–178.

    Article  PubMed  Google Scholar 

  22. Zelek L, Llombart-Cussac A, Terrier P, Pivot X, Guinebretiere JM, Le Pechoux C, et al. Prognostic facors in primary breast sarcomas: A series of patients with long-term follow-up. J Clin Oncol 2003;21:2583–2588.

    Article  CAS  PubMed  Google Scholar 

  23. Fein DA, Lee WR, Lanciano RM, Corn BW, Herbert SH, Hanlon AL, et al. Management of extremity soft tissue sarcomas with limb-sparing surgery and postoperative irradiation: do total dose, overall treatment time, and the surgery-radiotherapy interval impact on local control? Int J Radiat Oncol Biol Phys 1995;32:969–976.

    Article  CAS  PubMed  Google Scholar 

  24. Suit HD, Mankin HJ, Wood WC, Gebhardt MC, Harmon DC, Rosenberg A, et al. Treatment of the patient with stage M0 soft tissue sarcoma. J Clin Oncol 1988;6:854–862.

    CAS  PubMed  Google Scholar 

  25. McGowan TS, Cummings BJ, O’sullivan B, Catton CN, Miller N, Panzarella T. An analysis of 78 breast sarcoma patients without distant metastases at presentation. Int J Radiat Oncol Biol Phys 2000;46:383–390.

    Article  CAS  PubMed  Google Scholar 

  26. Johnstone PA, Pierce LJ, Merino MJ, Yang JC, Epstein AH, DeLaney TF. Primary soft tissue sarcomas of the breast: localregional control with post-operative radiotherapy. Int J Radiat Oncol Biol Phys 1993;27:671–675.

    Article  CAS  PubMed  Google Scholar 

  27. Adem C, Reynolds C, Ingle JN, Nascimento AG. Primary breast sarcoma: clinicopathologic series from the Mayo Clinic and review of the literature. Br J Cancer 2004;91:237–241.

    CAS  PubMed  Google Scholar 

  28. Nascimento AF, Raut CC, Fletcher CDM. Primary angiosarcoma of the breast. Clinicopathologic analysis of 49 cases suggesting that grade in not prognostic. Am J Surg Pathol 2008;32:1896–1904.

    Article  PubMed  Google Scholar 

  29. Shet T, Malaviya M, Kakade A, Kakade A, Parmar V, Badwe R, et al. Primary angiosarcoma of the breast. Observations in Asian Indian women. J Surg Oncol 2006;94:368–374.

    Article  PubMed  Google Scholar 

  30. Pisters PW, Leung DH, Shi W, Woodruff J, Brennan MF. Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities. J Clin Oncol 1996;14:1679–1689.

    CAS  PubMed  Google Scholar 

  31. Lahat G, Tuvin D, Wei C, Anaya DA, Bekele BN, Lazar AJ, et al. New perspectives for staging and prognosis in soft tissue sarcoma. Ann Surg Oncol 2008;15:2739–2748.

    Article  CAS  PubMed  Google Scholar 

  32. Donnell RM, Rosen PP, Lieberman PH, Kaufman RJ, Kay S, Braun DW Jr, et al. Angiosarcoma and other vascular tumors of the breast: Pathologic analysis as a guide to prognosis. Am J Surg Pathol 1981;5:629–642.

    Article  CAS  PubMed  Google Scholar 

  33. Merino MJ, Berman M, Carter D. Angiosarcoma of the breast. Am J Surg Pathol 1983;7:53–60.

    Article  CAS  PubMed  Google Scholar 

  34. Luini A, Gatti G, Diaz J, Botteri E, Oliveira E, Cecilio Sahium de Almeida R, et al. Angiosarcoma of the breast: the experience of the European Institute of Oncology and a review of the literature. Breast Cancer Res Treat 2007;105:81–85.

    Article  PubMed  Google Scholar 

  35. Pandey M, Mathew A, Abraham EK, Rajan B. Primary sarcoma of the breast. J Surg Oncol 2004;87:121–125.

    Article  PubMed  Google Scholar 

  36. Barrow BJ, Janjan NA, Gutman H, Benjamin RS, Allen P, Romsdahl MM, et al. Role of radiotherapy in sarcoma of the breast — a retrospective review of the M.D. Anderson experience. Radiother Oncol 1999;52:173–178.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kaklamanos, I.G., Birbas, K., Syrigos, K.N. et al. Breast angiosarcoma that is not related to radiation exposure: A comprehensive review of the literature. Surg Today 41, 163–168 (2011). https://doi.org/10.1007/s00595-010-4341-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-010-4341-x

Key words

Navigation