title: [Secondary Angiosarcoma of the Breast after Breast-conserving Therapy].
abstract: BACKGROUND
  Mammography for the detection of early stage breast cancer is widely established. Breast-conserving therapy followed by radiation therapy is the most common therapy for early stage breast cancer. Due to the increasing use of radiation therapy in breast cancer, secondary neoplasia are induced. The most common secondary neoplasia of the breast is the angiosarcoma. It occurs 4-7 years after radiation therapy. Genetic predisposition and a transformation of endothelial cells by radiation therapy are known to lead to angiosarcoma.
  
  
  OBJECTIVE
  The present paper outlines a concept for treatment on the basis of the current literature and the experience of the authors.
  
  
  CONCLUSIONS
  Radical surgical resection of the tumour with a sufficient margin of safety is the treatment of choice for angiosarcoma. Tumour infiltration of the chest wall and other local structures are challenges for the surgeon performing a radical tumour resection. The replacement of the tissue is also demanding for the surgeon. After radiation therapy the reconstructive options are limited. Individual factors such as age, quality of local vessels and the patients demand for breast reconstruction should be considered. Although R0 resection is performed, the 5-year survival rates are 20-30%.
authors.affiliation: Plastische und Ästhetische Chirurgie, Handchirurige, Zentrum für Schwerbrandverletzte, Sana Klinikum Offenbach,Offenbach.
authors.forename: P
authors.initials: P
authors.lastname: Wiebringhaus
authors.affiliation: Plastische und Ästhetische Chirurgie, Handchirurige, Zentrum für Schwerbrandverletzte, Sana Klinikum Offenbach,Offenbach.
authors.forename: A
authors.initials: A
authors.lastname: Gröger
authors.affiliation: Plastische und Ästhetische Chirurgie, Handchirurige, Zentrum für Schwerbrandverletzte, Sana Klinikum Offenbach,Offenbach.
authors.forename: H
authors.initials: H
authors.lastname: Menke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006394:Hemangiosarcoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D006801:Humans; D016462:Mammaplasty / Q000379:methods; D008327:Mammography; D015409:Mastectomy, Radical / Q000379:methods; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D012086:Reoperation; D013524:Surgical Flaps / Q000601:surgery