Angiosarcoma of the breast.
BACKGROUND
Angiosarcoma of the breast is a rare entity. The objectives of this study were to evaluate prognostic factors and determine outcomes in a large contemporary series of patients.


METHODS
Clinical and pathologic factors were analyzed in all patients with angiosarcoma of the breast treated between 1990 and 2003. Overall survival (OS) and disease-free survival (DFS) were estimated using the methods of Kaplan and Meier. Multivariate analyses were performed to evaluate prognostic factors.


RESULTS
Fifty-five women with angiosarcoma of the breast were identified. The median age was 49.1 years, and the median follow-up time was 3.7 years. The median OS and DFS were 2.96 years and 2.26 years, respectively. For the 32 patients with primary angiosarcoma of the breast 5-year OS was 59%. Twenty-three (42%) patients had received prior radiation therapy for the treatment of breast cancer. These patients with radiation therapy-associated angiosarcoma were on average 30 years older and less likely to present with distant metastatic disease than patients presenting with radiation-naive angiosarcoma of the breast. Although radiation-naive patients appeared to have had better early DFS and OS, the Kaplan-Meier curves were not statistically different between patients with radiation therapy-associated disease and radiation therapy-naive patients. On multivariate analysis, tumor recurrence (P = 0.006) was the only significant adverse prognostic factor noted for OS.


CONCLUSIONS
In this series of 55 patients with angiosarcoma of the breast, radiation therapy-naive angiosarcomas occurred in younger patients, but they behaved similarly to radiation therapy-associated angiosarcomas.
Vorburger
Stephan A
SA
The Multidisciplinary Sarcoma Center, The University of Texas MD Anderson Cancer Center, Houston, 77230, USA.
Xing
Yan
Y
Hunt
Kelly K
KK
Lakin
Gregory E
GE
Benjamin
Robert S
RS
Feig
Barry W
BW
Pisters
Peter W T
PW
Ballo
Matthew T
MT
Chen
Lei
L
Trent
Jonathan
J
Burgess
Michael
M
Patel
Shreyaskumar
S
Pollock
Raphael E
RE
Cormier
Janice N
JN
D000328:Adult; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D006394:Hemangiosarcoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007150:Immunohistochemistry; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis