title: Primary angiosarcomas of the breast.
abstract: BACKGROUND
  The purpose of the study was to describe the clinicopathologic characteristics and clinical outcomes of patients with primary breast angiosarcoma.
  
  
  METHODS
  The institutional database was searched to identify breast angiosarcoma patients seen between 1965 and 2002. Survival outcomes were estimated by the Kaplan-Meier method. The log-rank test was used to compare groups. Cox proportional hazards models were used for multivariate analysis.
  
  
  RESULTS
  In all, 69 patients were identified. Median follow-up was 40 months (range, 0-413 months). Median age was 46. Median tumor size at diagnosis was 5.5 cm. Thirteen (18.8%) patients received prior radiation for invasive breast carcinoma. Most patients underwent total mastectomy with (41%) or without (45%) axillary dissection. Regional metastasis to axillary lymph nodes was rare. There were 38 recurrences and 27 deaths. The 5-year overall (OS) and recurrence-free survival (RFS) rates were 61% (95% confidence interval [CI], 49%-76%) and 44% (95% CI, 33%-58%) with estimated medians of 100 and 37 months, respectively. In Cox proportional hazards models, OS and RFS were significantly associated only with T size and not with patient age, prior radiation, or chemotherapy administration. Of 29 patients treated with chemotherapy at recurrence, there were 4 complete and 10 partial responses (48%) with an anthracycline-ifosfamide or gemcitabine-taxane combination.
  
  
  CONCLUSIONS
  Breast angiosarcoma is frequently advanced at diagnosis and has a tendency for local-regional recurrence. A significant number of responses to chemotherapy was observed in the metastatic setting. These data suggest that a multidisciplinary therapeutic approach should be employed in high-risk patients with large primary tumors.
authors.affiliation: Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, Florida, USA.
authors.forename: Taimur
authors.initials: T
authors.lastname: Sher
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Hennessy
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.forename: Krisitine
authors.initials: K
authors.lastname: Broglio
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Woodward
authors.forename: Jonathan
authors.initials: J
authors.lastname: Trent
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Hunt
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hortobagyi
authors.forename: Ana M
authors.initials: AM
authors.lastname: Gonzalez-Angulo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006394:Hemangiosarcoma / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D016019:Survival Analysis
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone