Sarcomas following radiation therapy for breast cancer: a report of three cases and a review of the literature.
OBJECTIVE
First to describe clinical and pathologic features of sarcomas arising after radiation therapy for breast cancer and to report three cases of sarcoma arising 7, 15, and 20 years following radiation therapy for breast cancer. Second, to review the literature on this treatment complication.


METHODS
Medline literature search.


RESULTS
The most frequent histology is osteosarcoma and bone is affected more commonly than soft tissue at a median latency of 11 years. The scapula is the most frequently affected bone. The most frequently affected soft tissue site is now the conserved breast with a median latency of 5.5 years. The aetiologic factors relating to these sarcomas are not fully defined with factors of beam energy, radiation dose, chemotherapy and regional edema being inconsistently reported.


CONCLUSIONS
The frequency of radiation-induced sarcoma at 10 years of follow-up is approximately 0.2%. This is an overestimate by an unknown factor because of the description of sarcomas arising metachromously in breast cancer patients, in nonirradiated areas.
Department of Radiation Oncology, Westmead Hospital, N.S.W., Australia.
S C
SC
Pendlebury
M
M
Bilous
A O
AO
Langlands
D000328:Adult; D001859:Bone Neoplasms / Q000209:etiology / Q000473:pathology; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006394:Hemangiosarcoma / Q000209:etiology / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000473:pathology; D012516:Osteosarcoma / Q000209:etiology / Q000473:pathology; D011878:Radiotherapy / Q000009:adverse effects*; D012509:Sarcoma / Q000209:etiology* / Q000473:pathology