Primary Angiosarcoma Of Breast Research Articles

An interesting pathological diagnosis: Angiosarcoma of breast

<p>Primary angiosarcoma of breast is an extremely unusual variant of breast malignancies and its incidence is about 0.05% of all primary breast malignancies. Herein, we are presenting an unusual case of an 84 year old female patient with primary angiosarcoma of breast, which was diagnosed by fine needle aspiration cytology (FNAC) and confirmed with histopathology and immunohistochemistry approaches. She was treated with modified radical mastectomy (MRM), followed by radiotherapy and was observed to be recovering well based on the last 10 months of her post-treatment follow-up visit.</p>

Management experiences of primary angiosarcoma of breast: a retrospective study from single institute in the People's Republic of China.

BackgroundPrimary angiosarcoma of breast (PAOB) is a rare and highly aggressive malignancy. There is no general agreement on optimal treatments or prognostic factors for this orphan disease. The objective of this study was to investigate the clinicopathologic features and management experiences of PAOB.MethodsWe performed a retrospective review of medical and pathologic records of 17 consecutive patients diagnosed with PAOB between January 2000 and February 2014 at FuDan University Shanghai Cancer Center. We evaluated the clinical characteristics, multimodality treatments, and associated clinical outcomes.ResultsA total of 16 patients were included in this retrospective study (median age at PAOB presentation 33.5 years, range: 19–56 years). Palpable tumor with or without breast skin ecchymosis presented as the most common initial symptom. All patients underwent surgery with curative intent. Median disease-free survival and overall survival (OS) were 9 months and 13.6 months, respectively. One-year and 3-year disease-free survival rates were 43.8% and 6.3%, with OS rates of 93.8% and 78.1%, respectively. High histologic grade indicated poorer OS by univariate analysis (P=0.01). However, neither adjuvant chemotherapy nor radiotherapy contributed to clinical outcomes in our series.ConclusionPAOB is considered as an infrequent breast neoplasm with aggressive characteristics. Histologic grade and early metastasis (within 12 months after diagnosis) are associated with poor prognosis. Regardless of grade, additional benefit was not observed with adjuvant therapy.

Clinicopathological features of breast angiosarcoma.

Breast angiosarcomas are rare neoplasm. Due to its rarity, our therapeutic strategy is extremely limited. Therefore, we investigated the clinicopathologic features and examined the treatment for angiosarcoma compared with some literatures. We conducted a retrospective chart and slide review of all patients in our division seen from 1997 to 2012 with a diagnosis of primary or secondary breast angiosarcoma at the National Cancer Center Hospital (Tokyo, Japan). Nine patients were diagnosed with breast angiosarcoma (six primary and three secondary cases). The median age of patients with primary angiosarcoma was 39years (range 27-65years). The median tumor size was 6.78cm (range 3.0-8.8cm). In the primary tumor, 4 patients had total mastectomy and 2 had a breast conserving surgery. 3- and 5-year disease-free survival (DFS) of the patients with primary angiosarcoma was 20 and 0%. 5-year surviving rate of primary angiosarcoma was 50%. In all patients with secondary angiosarcoma, recurrence was observed in all cases. But one case obtained long-term survival in local control therapy. Our study demonstrates breast angiosarcoma exhibits high recurrence rates. Tumor size and surgical margin may be important factor to obtain long-term survival. In this point of view, total mastectomy with adequate tumor margin with early detection is desired. In case of recurrence, if it is local, surgery may be potentially curative.

Primary angiosarcoma of breast: a case report.

Primary breast sarcomas are rare entities. These malignant tumors originate from mesenchymal glandular breast tissue and account for <1% of all breast cancer cases. Angiosarcomas are rare malignant tumors that arise from endothelial cells lining vascular channels. Most angiosarcomas are secondary to radiotherapy treatments for breast cancer or to an arm lymphoedema subsequent to a modified radical mastectomy. Primary angiosarcomas are rare and account for 0.04% of all malignant breast tumors.

Angiosarcoma primario y secundario de mama: estudio de 8 casos con evidencia de origen linfático en los angiosarcomas posradioterapia

ObjectiveTo analyze differences between primary and radiation-associated secondary breast angiosarcomas. Patients and methodsWe retrospectively reviewed all cases of angiosarcoma diagnosed at our hospital between 2000 and 2010. We analyzed the clinical and pathological features. In the immunohistochemical study, we assessed expression of CKAE1/AE3, CD31, CD34, Ki-67 and D2-40. ResultsThere were 8 women, 4 with primary angiosarcoma and 4 with secondary angiosarcoma. The mean age at presentation was 66 years for primary tumors and 74 years for secondary angiosarcomas. The mean latency period for radiation-associated angiosarcomas was 118 months. Three secondary tumors involved the skin, 3 primary angiosarcomas were intramammary and the remaining 2 were mixed. All tumors were CD31+/CD34+/CKAE1/AE3−. The secondary angiosarcomas also expressed D2-40, while the primary tumors were negative for this lymphatic marker. ConclusionsSecondary angiosarcomas express D2-40, while primary angiosarcomas are negative for this lymphatic marker. This finding suggests a lymphatic origin for post-radiation angiosarcomas.

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Clinical Experience of Stewart-Treves Syndrome in the Lower Leg

Clinical Experience of Stewart-Treves Syndrome in the Lower Leg

Bilateral Primary Angiosarcoma of the Breast

Primary breast sarcomas are very rare entities, accounting for 0.04% of all malignant neoplasms. Angiosarcoma of breast is infrequent and is an endothelial malignant tumor with bad prognosis because of the frequency of metastasis and recurrence. We present a case of a 30-year-old female who presented with an ulcerated left breast lesion which on further workup revealed to be a primary angiosarcoma of breast with metastasis to right breast.

Primary angiosarcoma of breast: A case report

INTRODUCTIONPrimary breast angiosarcoma is a rare form of breast cancer, accounting for only 0.04% of all malignant breast tumours. PRESENTATION OF CASEA 28-year-old woman presented with a progressive lump in the right breast for one month. Fine needle aspiration cytology (FNAC) was highly suspicious of angiosarcoma, and this diagnosis was confirmed on core needle biopsy. Modified radical mastectomy was performed as sole treatment. DISCUSSIONPrimary breast angiosarcoma is a rare type of breast malignancy, usually occurring in the third to fourth decade and only reported in women. The histological features of angiosarcoma of the breast are conventionally graded I, II or III. Total mastectomy appears to be the only treatment conferring benefit, chemotherapy and radiation therapy being of little proven value to date. The 5-year disease-free survival for grade I tumours can be as high as 76%, and up to 70% for grade II tumours whereas for grade III tumours it is reportedly about 15%. CONCLUSIONPrimary angiosarcoma of the breast is a rare malignancy with a poor prognosis, even after complete resection. Surgery is the mainstay of treatment with a limited role for chemotherapy and radiotherapy.

Breast angiosarcoma one year after adenosquamous endometrial cancer — diagnostic pitfalls

Abstract Angiosarcoma of the breast is a rare and very aggressive tumors originated from endothelial cells lining blood vessels. We report a case of a 55-year-old postmenopausal female with a primary breast angiosarcoma diagnosed just a one year after radical hysterectomy and radiation therapy due to endometrial cancer. The patient initially presented with postmenopausal bleeding. Cytology and biopsy of the endometrium were performed and endometrial adenosquamous carcinoma was diagnosed followed by radical hysterectomy and postoperative local radiatiotherapy (50 Gy). One year later patient presented with a great painful tumorous mass in the right breast. Physical examination revealed an oval tumor, located in upper and outer quadrant of the right breast, around 15 cm in diameter. Mammography and ultrasonography were performed. The angiosarcoma of the breast was confirmed by biopsy. The patient underwent radical mastectomy. Histopathology proved the diagnosis of angiosarcoma (high-grade, numerous mitoses over 10/10 HPF, necrosis, “blood lakes”, infiltrative borders). Differential diagnosis of a breast angiosarcoma should be considered in all painful breast tumours no mather the time and the location of the previous radiation treatment even if benign characteristics of these masses have been detected by mammography and breast ultrasound.

A transcriptome signature of endothelial lymphatic cells coexists with the chronic oxidative stress signature in radiation-induced post-radiotherapy breast angiosarcomas

Radiation-induced breast angiosarcomas are rare but recognized complication of breast cancer radiotherapy and are of poor prognosis. Little is known about the genetic abnormalities present in these secondary tumors. Herein, we investigated the differences in the genome and in the transcriptome that discriminate these tumors as a function of their etiology. Seven primary breast angiosarcomas and 18 secondary breast angiosarcomas arising in the irradiation field of a radiotherapy were analyzed. Copy number alterations and gene expression were analyzed using Affymetrix SNP 6.0 Array and Affymetrix Exon Arrays, respectively. We showed that two transcriptome signatures of the radiation tumorigenesis coexisted in these tumors. One was histology specific and correctly discriminated 100% of the primary tumors from the radiation-induced tumors. The deregulation of marker genes, including podoplanin (PDPN), prospero homeobox 1 (PROX-1), vascular endothelial growth factor 3 (VEGFR3) and endothelin receptor A (EDNRA), suggests that the radiation-induced breast angiosarcomas developed from radiation-stimulated lymphatic endothelial cells. None of the genes of the histology-specific signature were present in our previously published signature of the radiation tumorigenesis which shows the presence of a chronic oxidative stress in radiation-induced sarcomas of various histologies. Nevertheless, this oxidative stress signature classified correctly 88% of the breast angiosarcomas as a function of the etiology. In contrast, MYC amplification, which is observed in all radiation-induced tumors but also at a low rate in primary tumors, was not a marker of the radiation tumorigenesis.

Angiosarcoma of the breast: A difficult surgical challenge

Background and objectivesBreast angiosarcoma presents following radiotherapy after breast conserving surgery, in the setting of chronic lymphoedema after axillary dissection or as a primary tumour. The Peter MacCallum Cancer Centre has significant experience due to large breast and sarcoma units and as a primary radiotherapy centre. Our aims were to evaluate the management and locoregional and distant outcomes after breast angiosarcoma. MethodsRetrospective study of all patients from the prospective breast and sarcoma databases with a diagnosis of primary or secondary breast angiosarcoma at Peter MacCallum Cancer Centre was performed between January 2000 and December 2010. Mode of presentation, management, loco-regional recurrence and survival rates were reviewed. ResultsEight women developed angiosarcoma in the setting of breast conservation with a median latency of 7 years post radiotherapy. Six patients had primary breast angiosarcoma. All breast angiosarcomas were managed with total mastectomy with 5 patients requiring autologous tissue transfer. Four patients had adjuvant radiotherapy and three patients had adjuvant paclitaxel. The median follow-up was 2.5 years (6 month-10 years) with 7 episodes of local recurrence in four patients and 7 patients with distal metastases including two deaths from distant disease. ConclusionsPrimary angiosarcoma occurs de novo, presenting as a breast mass. Secondary angiosarcoma presents predominantly as a skin lesion, in the setting post-operative radiotherapy for breast conserving therapy. Angiosarcoma remains a rare and difficult management problem with poor loco-regional and distal control. Secondary AS is an iatrogenic condition that warrants close follow-up and judicial use of radiotherapy in breast conserving therapy.

Primary Cutaneous Angiosarcoma of the Breast After Breast Trauma

Primary angiosarcoma of the breast is a rare malignant tumor. We report a case of breast primary cutaneous angiosarcoma in a patient with a strong family history of malignancy. For definitive diagnosis, a tissue biopsy is needed, with immunostaining for the presence of blood vessel endothelial markers CD31 and CD34. Total mastectomy is the preferred method of surgical treatment. Chemotherapy has not been shown to increase overall survival, but in some instances it may improve local control and disease-free survival. Surgery combined with radiation may increase local control, but patients at high risk of recurrence may benefit from adjuvant treatment as well. We discuss the potential benefits from various treatments for primary cutaneous breast angiosarcoma.

A case report of primary breast angiosarcoma with fatal pulmonary hemorrhage due to thrombocytopenia

Primary angiosarcomas of the breast are rare malignancy that account for fewer than 0.04% of all malignant breast tumors. The prognosis is poor. Surgery is the first line of treatment for angiosarcoma. Adjuvant chemotherapy and radiotherapy have been tried, but their efficacy remains controversial. Here we present the case of a 47-year-old woman with a palpable left breast mass that was diagnosed as a primary angiosarcoma. The patient underwent modified radical mastectomy with adjuvant chemotherapy and radiotherapy. Postoperatively, eighteen months later, the angiosarcoma recurred. The patient returned complaining of dyspnea and hemoptysis and was found to have a large pleural effusion. She developed a gradual onset of thrombocytopenia that persisted despite platelet transfusions. Finally, the patient died of respiratory failure secondary to pulmonary hemorrhage.

Primary and secondary angiosarcomas of the breast: a single institution experience

Angiosarcomas of the breast (ASB) are rare, representing <1% of breast malignancies. They can develop as a primary or secondary malignancy, also called post-radiation angiosarcoma. The aim of the this study is to discuss diagnosis, treatment, and outcome of primary and secondary ASB patients, diagnosed and treated in a single institution, over a 10-year period and to further compare the two conditions. We retrieved 28 consecutive cases of ASB, diagnosed from 1999 to 2009 at the European Institute of Oncology. Clinical and pathologic findings and survival analyses were performed. Of the 28 cases (27 women and 1 man), eight were primary breast angiosarcomas (PBA) and 20 were secondary breast angiosarcomas (SBA). Median follow-up was 23 months (range 1-112 months). Type of treatment (conservative or radical surgery) did not affect survival in both types of angiosarcomas. The clinical course observed was characterized by a high rate of local recurrence rather than distant metastasis or death from disease. There was a correlation between histological grade and prognosis of angiosarcomas with high-grade tumors presenting worse prognosis. SBA had a poorer prognosis compared to PBA. Our data indicate that primary and secondary ASB are distinct clinical and pathological features. SBA showed worse prognosis and was more often diagnosed in the study period compared to PBA. Physicians who care for patients who have been treated with radiation must be aware of its potential to induce angiosarcoma and stay vigilant in its detection.

Large Clinical Experience of Primary Angiosarcoma of the Breast in a Single Korean Medical Institute

Angiosarcoma of the breast is rare. The purpose of the present study was to evaluate the clinicopathologic characteristics and the clinical outcomes of patients with primary breast angiosarcoma. We analyzed the clinicopathologic factors of patients with angiosarcoma of the breast treated between 1997 and 2010 at the Samsung Medical Center. We reviewed the related demographic data, preoperative imaging studies, method of histologic confirmation, tumor size, histologic grades, status of hormonal receptors, treatment modality, and survival data. Nine women with angiosarcoma of the breast were identified. The median age of patients with primary angiosarcoma of the breast at diagnosis was 31years (range: 19-63years), and the median tumor size was 9.0cm (range: 3.5-10.7cm). Seven patients (77.7%) died within a median follow-up of 46.7months (range: 3.9-63.3months), and all deaths were directly attributed to angiosarcoma. Overall, the median time from diagnosis of angiosarcoma to death was 46.8months (range: 8.21-63.3months). The 5year overall survival with angiosarcoma was 42.9%. Primary angiosarcoma of the breast is a rare malignancy with a poor prognosis, even with complete resection. Chemotherapy and radiation therapy have limited value as treatments to date. Total mastectomy appears to be the most appropriate and beneficial treatment. More aggressive surgical management should be considered, and future clinical research should explore the most appropriate adjuvant therapy in the treatment of angiosarcoma.

Benign “Waxing–Waning” Vascular Proliferations in Previously Irradiated Skin

Benign “Waxing–Waning” Vascular Proliferations in Previously Irradiated Skin

Primary Breast Angiosarcoma: Avoiding a Common Trap

Background. Primary breast angiosarcoma is a rare entity. Case. Initial diagnosis was a benign hemangioma at core biopsy. Wide local excision was performed, with positive margins. Pathology after surgery reported a moderately differentiated angiosarcoma. Tumor was finally treated using mastectomy and radiations. She developed a second angiosarcoma in contralateral breast, with an initial diagnosis on core biopsy of an atypical vascular lesion and was again treated using mastectomy and radiations. She developed bones and lung metastases. Conclusion. Primary breast angiosarcoma is a rare entity often difficult to diagnose on core biopsy, and a benign differential diagnosis is frequent. A highly vascular breast mass should always be considered malignant until proven otherwise. Surgical treatment seems to be the best course of action. There is a lack of data proving efficacy of adjuvant chemotherapy and radiation therapy.

Metastatic Primary Angiosarcoma of the Breast in a Pediatric Patient With a Complete Response to Systemic Chemotherapy and Definitive Radiation Therapy: Case Report and Review of the Literature

We present a case of a rare malignancy, primary breast angiosarcoma, in a 15-year-old girl. She presented with a locally advanced tumor and suspected metastatic disease to the mediastinum and bones on PET imaging. The patient was treated with systemic chemotherapy and definitive radiation therapy to her left breast and achieved a complete response. She has no evidence of disease recurrence 44 months from her initial diagnosis.

Breast Angiosarcoma

Abstract: Primary and secondary angiosarcoma of the breast is a rare aggressive disease with a poor prognosis. Radiographic features of breast angiosarcoma on mammography, ultrasound and MRI have been studied but F-18 fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) findings have not been described. We present illustrations of FDG PET/CT findings of primary and secondary breast angiosarcoma, respectively. In both cases, intense FDG activity was demonstrated within the primary tumor as well as metastatic disease. FDG PET/CT imaging findings may be useful in initial staging and restaging patients with angiosarcomas. Follow-up studies can be used to document therapeutic response by showing interval resolution of FDG activity.