Primary and secondary breast angiosarcoma: single center report and a meta-analysis

Yara Abdou, Ahmed Elkhanany, Kristopher Attwood, Wenyan Ji, Kazuaki Takabe, Mateusz Opyrchal

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations

Abstract

Background: Primary and secondary breast angiosarcoma is a rare and aggressive malignancy with limited published literature. Optimal management is mostly based on expert opinion. Our study aims to describe a single institution experience with breast angiosarcoma and evaluate other publications on this topic to further clarify prognostic outcomes and treatment modalities in this disease. Methods: Twenty two cases of breast angiosarcoma from Roswell Park Comprehensive Cancer Center were retrospectively analyzed. Additionally, a systemic review and meta-analysis was conducted to study the association between survival outcomes, overall survival (OS), and recurrence-free survival (RFS) in both primary (PAS) and secondary breast angiosarcoma (SAS). Results: 9 PAS patients (41%) and 13 SAS patients (59%) were retrospectively analyzed. No significant differences were noted in tumor characteristics and survival outcomes between PAS and SAS. Treatment modality had no significant effects on survival outcomes although adjuvant chemotherapy demonstrated a trend towards improved RFS in high grade tumors. 380 PAS and 595 SAS patients were included in the outcome meta-analysis. Survival outcomes were significantly worse with high grade tumors and tumor size of > 5 cm. Adjuvant radiation therapy demonstrated significantly better RFS, while adjuvant chemotherapy had no effect on survival outcomes. Conclusion: Tumor size and grade seem to be reliable predictors of survival in both PAS and SAS. Mastectomy does not seem to be adding any additional benefit to BCS. Adjuvant radiation therapy showed statistically significant RFS benefit, while adjuvant chemotherapy can be beneficial in high grade tumors.

Original languageEnglish
Pages (from-to)523-533
Number of pages11
JournalBreast Cancer Research and Treatment
Volume178
Issue number3
DOIs
StatePublished - Dec 1 2019

Keywords

  • Breast angiosarcoma
  • Case–control study
  • Meta-analysis
  • Primary angiosarcoma
  • Secondary angiosarcoma
  • Stewart–Treves syndrome

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