title: The risk of angiosarcoma following primary breast cancer.
abstract: Lymphangiosarcoma of the upper extremity is a rare and aggressive tumour reported to occur following post-mastectomy lymphoedema (Stewart-Treves syndrome). Haemangiosarcoma, a related rare tumour, has occasionally been reported to occur in the breast following irradiation. We conducted a case-control study using the University of Southern California-Cancer Surveillance Program, the population-based cancer registry for Los Angeles County, to evaluate the relationship between invasive female breast cancer and subsequent upper extremity or chest lymphangiosarcoma and haemangiosarcoma together referred to as angiosarcoma. Cases were females diagnosed between 1972 and 1995 with angiosarcoma of the upper extremity (n = 20) or chest (n = 48) who were 25 years of age or older and residing in Los Angeles County when diagnosed. Other sarcomas at the same anatomic sites were also studied. Controls were females diagnosed with cancers other than sarcoma during the same time period (n = 266,444). Cases and controls were then compared with respect to history of a prior invasive epithelial breast cancer. A history of breast cancer increased the risk of upper extremity angiosarcoma by more than 59-fold (odds ratio [OR] = 59.3, 95% confidence interval [95% CI] = 21.9-152.8). A strong increase in risk after breast cancer was also observed for angiosarcoma of the chest and breast (OR = 11.6, 95% CI = 4.3-26.1) and for other sarcomas of the chest and breast (OR = 3.3, 95% CI = 1.1-1.7).
authors.affiliation: University of Southern California School of Medicine, Department of Preventive Medicine, Los Angeles 90033, USA.
authors.forename: W
authors.initials: W
authors.lastname: Cozen
authors.forename: L
authors.initials: L
authors.lastname: Bernstein
authors.forename: F
authors.initials: F
authors.lastname: Wang
authors.forename: M F
authors.initials: MF
authors.lastname: Press
authors.forename: T M
authors.initials: TM
authors.lastname: Mack
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000628:therapy; D002277:Carcinoma / Q000453:epidemiology* / Q000628:therapy; D016022:Case-Control Studies; D005260:Female; D005354:Fibrosarcoma / Q000453:epidemiology; D006394:Hemangiosarcoma / Q000453:epidemiology*; D018219:Histiocytoma, Benign Fibrous / Q000453:epidemiology; D006801:Humans; D016013:Likelihood Functions; D015141:Los Angeles / Q000453:epidemiology; D008197:Lymph Node Excision / Q000009:adverse effects; D008204:Lymphangiosarcoma / Q000453:epidemiology; D015409:Mastectomy, Radical / Q000009:adverse effects; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D016017:Odds Ratio; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012306:Risk; D012983:Soft Tissue Neoplasms / Q000453:epidemiology*; D013909:Thorax