Breast Angiosarcoma: A Clinicopathologic Study
Anca V Florea, David J Dabbs, Sushil Beriwal, Rohit Bhargava. Jewish General Hospital/McGill University, Montreal, Canada; Magee-Womens Hospital/University of Pittsburgh Medical Center, Pittsburgh
Background: Angiosarcoma of the breast is a rare disease where histologic grade is considered prognostic. Angiosarcomas can be divided into primary (de novo) and secondary (secondary to radiation treatment for prior breast carcinoma). The objective was to determine clinicopathologic factors associated with primary and secondary breast angiosarcoma.
Design: All cases of breast angiosarcoma diagnosed at our institution from 1996 to 2011 were identified. Clinicopathologic factors were reviewed. Characteristics of primary and secondary angiosarcoma were compared.
Results: A total of 35 cases were identified. Seven were primary and 22 were secondary angiosarcoma. Six cases (all consults) could not be classified due to lack of clinical information. The median age of primary angiosarcoma patients was slightly lower than that of secondary angiosarcoma-60 years versus 71 years, but the difference was not statistically significant. Primary angiosarcomas were less often high grade compared to secondary angiosarcomas (43% versus 90%; p=0.0239). No statistical difference was noted in tumor size between primary and secondary angiosarcoma. Median time from radiation to secondary angiosarcoma diagnosis was 7 years. One of 7 primary angiosarcoma patient received chemotherapy. Chemotherapy information was available on 18 secondary angiosarcoma cases of which only 2 received chemotherapy. The 2 secondary angiosarcoma patients that received chemotherapy still recurred within one year of diagnosis. Five-year disease free survival (DFS) for primary and secondary angiosarcoma was 43% and 56%, respectively (p=0.6728). Five year overall survival (OS) rate for primary and secondary angiosarcoma was 71% and 56%, respectively (p=0.6592). The five year DFS and OS was also not statistically significant between low grade and high grade angiosarcomas, regardless of the primary/secondary status.
Conclusions: Secondary angiosarcomas are more common than primary tumors. Secondary angiosarcoma cases are more often high grade compared to primary angiosarcoma but that does not seem to affect the DFS or OS. Oncologists infrequently use chemotherapy for angiosarcoma due to lack of effective regimens. Breast angiosarcoma is an aggressive disease for which novel therapeutic approaches are required.
Monday, March 19, 2012 1:00 PM
Poster Session II # 48, Monday Afternoon