title: Multidisciplinary approach to breast angiosarcoma in an elderly patient: Repeated local relapses and significant objective responses.
abstract: Angiosarcomas are malignant tumors of endovascular origin, which may be divided into primary and secondary forms. Secondary breast angiosarcomas are an increasing problem, especially in patients treated with breast-conserving surgery followed by radiotherapy.We report a case of radiation-induced angiosarcoma of the breast in a 77-year-old woman who presented with a suspect lesion in her left breast. Excisional biopsy and subsequent immunohistochemical staining of the specimen was performed. Histological report was diagnostic for low-intermediate grade angiosarcoma. The tumor cells were diffusely positive for CD31 and CD34. We performed surgical resection with mastectomy.A multidisciplinary approach with bleomycin-based electrochemotherapy, radiation treatment, and chemotherapy with pegylated liposomal doxorubicin has been most useful to control subsequent local relapses. To date, the patient is under close observation and is performing well. No recurrence has been demonstrated after ending of chemotherapy.
authors.affiliation: Department of Medical, Surgical, Neurologic, Metabolic and Ageing Sciences; Division of Internal Medicine; Second University of Study of Naples, Naples, Italy carmemocer@libero.it.
authors.forename: Carmela
authors.initials: C
authors.lastname: Mocerino
authors.affiliation: Department of Public, Clinic and Preventive Medicine; Division of Pathology; Second University of Study of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Iannaci
authors.affiliation: Department of Public, Clinic and Preventive Medicine; Division of Pathology; Second University of Study of Naples, Naples, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Sapere
authors.affiliation: Department of Public, Clinic and Preventive Medicine; Division of Pathology; Second University of Study of Naples, Naples, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Luise
authors.affiliation: Department of Medical, Surgical, Neurologic, Metabolic and Ageing Sciences; Division of General and Geriatric Surgery; Second University of Study of Naples, Naples, Italy.
authors.forename: Silvestro
authors.initials: S
authors.lastname: Canonico
authors.affiliation: Department of Medical, Surgical, Neurologic, Metabolic and Ageing Sciences; Division of Internal Medicine; Second University of Study of Naples, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gambardella
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006394:Hemangiosarcoma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008408:Mastectomy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D009381:Neoplasms, Radiation-Induced / Q000473:pathology / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000473:pathology / Q000601:surgery; D012008:Recurrence
keywords: breast angiosarcoma; elderly; pegylated liposomal doxorubicin