Clinical outcomes in breast angiosarcoma patients: A rare tumor with unique challenges

被引:24
作者
Gervais, Mai-Kim [1 ,2 ,3 ]
Burtenshaw, Sally M. [1 ,2 ,3 ]
Maxwell, Jessica [1 ,2 ,3 ]
Dickson, Brendan C. [4 ]
Catton, Charles N. [5 ]
Blackstein, Martin [6 ,7 ]
McCready, David [1 ,2 ,3 ]
Escallon, Jaime [1 ,2 ,3 ]
Gladdy, Rebecca A. [1 ,2 ,3 ]
机构
[1] Mt Sinai Hosp, Div Gen Surg, Toronto, ON, Canada
[2] Princess Margaret Canc Ctr, Dept Surg Oncol, Toronto, ON, Canada
[3] Univ Toronto, Dept Surg, Toronto, ON, Canada
[4] Univ Toronto, Mt Sinai Hosp, Dept Pathol & Lab Med, Toronto, ON, Canada
[5] Univ Toronto, Princess Margaret Canc Ctr, Dept Radiat Oncol, Toronto, ON, Canada
[6] Univ Toronto, Mt Sinai Hosp, Dept Med Oncol, Toronto, ON, Canada
[7] Univ Toronto, Princess Margaret Canc Ctr, Toronto, ON, Canada
关键词
angiosarcoma; breast; radiation-associated sarcoma;
D O I
10.1002/jso.24780
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundBreast angiosarcoma (AS) accounts for less than 1% of all breast cancers. The goal of this study was to determine patient outcomes in radiation-associated angiosarcoma of the breast (RAAS) and sporadic AS. We evaluated patterns of recurrence and predictors of breast AS survival. MethodsPatients with pathologically confirmed AS from 1994 to 2014 referred to Mount Sinai Hospital/Princess Margaret Cancer Centre were included. Primary outcome was overall survival (OS). Secondary outcomes were disease-free survival (DFS), clinicopathologic characteristics, patterns of recurrence and factors predictive of survival. Kaplan-Meier and log-rank tests were used for OS and DFS. ResultsTwenty-six patients were included: 6 with sporadic AS and 20 with RAAS. Median follow-up was 24 months. Five-year OS for RAAS and sporadic subgroups were 44% and 40%, respectively (P=ns). Five-year DFS for RAAS and sporadic subgroups were 23% and 20%, respectively (P=ns). Overall recurrence rate was 67% with median time to recurrence of 11 months. Age, tumor depth, margin status, and tumor size were not statistically significant predictive factors for OS and DFS. DiscussionBreast AS is associated with poor survival and high recurrence rates. Prognosis may be mainly determined by its aggressive biology. Referral to tertiary care centers for multimodality treatment is recommended.
引用
收藏
页码:1056 / 1061
页数:6
相关论文
共 25 条
[1]  
Harris J.R., Lippman M.E., Morrow M., Osborne C.K., Diseases of the breast, pp. 800-803, (2010)
[2]  
Cahan W.G., Woodard H.Q., Higinbotham N.L., Et al., Sarcoma arising in irradiated bone
[3]  
report of eleven cases, Cancer, 1, pp. 3-29, (1948)
[4]  
Styring E., Seinen J., Dominguez-Valentin M., Et al., Key roles for MYC, KIT and RET signaling in secondary angiosarcomas, Br J Cancer, 101, pp. 407-411, (2014)
[5]  
Depla A.L., Scharloo-Karels C.H., De Jong M.A.A., Et al., Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer: a systematic review, Eur J Cancer, 50, pp. 1779-1788, (2014)
[6]  
Thornton K., Sarcomas of the breast with a spotlight on angiosarcoma and cystosarcoma phyllodes, Surg Oncol Clin N Am, 25, pp. 713-720, (2016)
[7]  
Gervais M.K., Gladdy R.A., Gupta A., Et al., Breast sarcoma, Textbook of Uncommon Cancer, (2017)
[8]  
Morgan E.A., Kozono D.E., Wang Q., Et al., Cutaneous radiation-associated angiosarcoma of the breast: poor prognosis in a rare secondary malignancy, Ann Surg Oncol, 19, pp. 3801-3808, (2012)
[9]  
Gladdy R.A., Qin L.X., Moraco N., Et al., Do radiation-associated soft tissue sarcomas have the same prognosis as sporadic soft tissue sarcomas, J Clin Oncol, 28, pp. 2064-2069, (2010)
[10]  
Torres K.E., Ravi V., Kin K., Et al., Long-term outcomes in patients with radiation-associated angiosarcomas of the breast following surgery and radiotherapy for breast cancer, Ann Surg Oncol, 20, pp. 1267-1274, (2013)