title: Surgical management of radiation-induced angiosarcoma after breast conservation therapy.
abstract: BACKGROUND
  Radiation-induced angiosarcoma (RA) is a well-recognized complication of breast conservation therapy (BCT).
  
  
  METHODS
  Over a 12-year period, 14 patients with a median age of 68 years were identified retrospectively. The median latency from BCT to onset of RA was 81 months. The incomplete excision rate (complete histologic margin taken to be > 10 mm) was 46%. There was a significant difference in the size of the cutaneous defect between the complete and incomplete excision groups (412 vs 592 cm(2), respectively; P < .05), indicating more extensive disease in the latter group.
  
  
  RESULTS
  The tumor recurred locally in 12 patients (92%). The median time to local recurrence (LR) in patients with incomplete excision was 3 versus 23 months in patients who had a complete excision. The median survival time for patients who underwent complete versus incomplete excision was 42 and 6 months, respectively.
  
  
  CONCLUSIONS
  RA is a challenging condition, with a prolonged latency period and variable clinical progression. Incomplete excision of RA is a surrogate marker of aggressive disease and is associated with rapid LR and poor survival.
authors.affiliation: Department of Plastic Surgery, Royal Marsden Hospital, London, United Kingdom. navidjallali@hotmail.com
authors.forename: Navid
authors.initials: N
authors.lastname: Jallali
authors.forename: Stuart
authors.initials: S
authors.lastname: James
authors.forename: Adam
authors.initials: A
authors.lastname: Searle
authors.forename: Amar
authors.initials: A
authors.lastname: Ghattaura
authors.forename: Andrew
authors.initials: A
authors.lastname: Hayes
authors.forename: Paul
authors.initials: P
authors.lastname: Harris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000209:etiology / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006394:Hemangiosarcoma / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D015413:Mastectomy, Simple; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009381:Neoplasms, Radiation-Induced / Q000401:mortality / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome