title: Grade and Prognosis in Localized Primary Angiosarcoma.
abstract: BACKGROUND
  Primary angiosarcoma of the breast (PAOB) is rare and institutional series have provided conflicting data on the effect of grade on prognosis.
  
  
  METHODS
  Using a case listing session of Surveillance, Epidemiology, and End Results (SEER) 18 (1973-2010) we examined outcomes for patients with PAOB. Analyses were conducted with SEER*Stat 8.1.2, Microsoft Excel 2007, and GraphPad Prism 6. Comparisons were made using the Fisher exact test and log rank test (Mantel-Cox); P values were 2-sided.
  
  
  RESULTS
  Two hundred twenty-six women with PAOB were identified; median age was 49 (range, 15-107) years and 82% (185) were white. Seventy-two percent (162) had localized disease, 15% (34) regional disease, 7% (16) distant disease, and 6% (14) had unknown staging. Fourteen percent (32) had Grade 1, 24% (55) Grade 2, 30% (68) Grade 3 disease, and grade was unknown in 32% (72) of patients. Median overall survival (OS) for patients with localized, regional, and distant disease was 172, 24, and 16 months, respectively (P < .001). Median OS for patients with localized Grade 1 and 2 disease was not reached versus 36 months for Grade 3 disease (P < .001); 3-year OS was 89% (78) versus 47% (32). There was a strong trend for patients with Grade 3 disease to undergo mastectomy (44%, n = 30 vs. 23%, n = 20; P = .070) and 24% (55) of all patients received radiation. Radiation did not improve survival for localized Grade 1 and 2 disease (P = .676), or Grade 3 disease (P = .589); surgery and grade subgroups were too small for meaningful comparisons regarding radiation.
  
  
  CONCLUSIONS
  Histologic grade is a significant predictor of survival for patients with localized PAOB. Regardless of grade, adjuvant radiation did not confer a survival benefit for patients with localized disease.
authors: Department of Medical Oncology, West Cancer Center/ University of Tennessee Health Science Center, Memphis, TN.
authors: Manjari
authors: M
authors: Pandey
authors: Department of Medical Oncology, West Cancer Center/ University of Tennessee Health Science Center, Memphis, TN.
authors: Gregory R
authors: GR
authors: Sutton
authors: Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN.
authors: Smith
authors: S
authors: Giri
authors: Department of Medical Oncology, West Cancer Center/ University of Tennessee Health Science Center, Memphis, TN. Electronic address: mmartin@westclinic.com.
authors: Mike G
authors: MG
authors: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006394:Hemangiosarcoma / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D018426:SEER Program; D055815:Young Adult
keywords: Angiosarcoma; Histologic grade; Radiation therapy; SEER