• Adjuvant radiotherapy
• Angiosarcoma
• Complete pathological response
• Multidisciplinary evaluation
• Neoadjuvant chemotherapy
• Neoadjuvant radiotherapy
• Outcome
• Timing of surgery
• Treatment optimization
• Tumor grade

• Humans
• Hemangiosarcoma/therapy
• Hemangiosarcoma/pathology
• Hemangiosarcoma/surgery
• Female
• Breast Neoplasms/therapy
• Breast Neoplasms/pathology
• Breast Neoplasms/surgery
• Middle Aged
• Retrospective Studies
• Aged
• Neoadjuvant Therapy
• Adult
• Chemotherapy, Adjuvant
• Mastectomy
• Survival Rate
• Time-to-Treatment
• Aged, 80 and over
• Radiotherapy, Adjuvant
• Neoplasm Grading
• Prognosis
• Neoplasms, Radiation-Induced

• Humans
• Hemangiosarcoma/etiology
• Hemangiosarcoma/radiotherapy
• Female
• Breast Neoplasms/radiotherapy
• Breast Neoplasms/pathology
• Re-Irradiation/adverse effects
• Neoadjuvant Therapy/adverse effects
• Middle Aged
• Aged
• Neoplasms, Radiation-Induced/etiology
• Adult
• Dose Fractionation, Radiation
• Retrospective Studies

• (neo)adjuvant chemotherapy
• Angiosarcoma
• Clinical management
• Clinical recommendations
• Localized disease
• Multimodal treatment
• Radiotherapy
• Surgery

• Humans
• Consensus
• Hemangiosarcoma/therapy
• Hemangiosarcoma/pathology
• Italy
• Practice Guidelines as Topic
• Sarcoma/therapy
• Sarcoma/pathology

• Mastectomy
• Primary angiosarcoma breast
• Rare disease

• Breast angiosarcoma
• Diagnosis
• Treatment

• breast angiosarcoma
• breast cancer
• breast radiation
• breast surgery
• case report

• breast angiosarcoma
• breast chondrosarcoma
• breast desmoid tumor
• breast leiomyosarcoma
• breast liposarcoma
• breast phyllodes tumor
• breast rhabdomyosarcoma
• breast sarcoma
• soft tissue sarcoma

• breast angiosarcoma
• primary breast angiosarcoma
• secondary breast angiosarcoma

• Humans
• Female
• Aged
• Hemangiosarcoma/diagnostic imaging
• Breast Neoplasms/diagnostic imaging
• Breast/pathology
• Skin/pathology

• Breast angiosarcoma
• Case report
• Core needle biopsy
• Immunohistochemistry
• Ultrasonography

• Breast cancer
• Breast surgery
• Pathology
• Radiology
• Surgical oncology

• Female
• Adolescent
• Humans
• Endothelial Cells
• Breast Neoplasms
• Breast
• Hemangiosarcoma

• angiosarcoma
• breast
• histologic grade

• Humans
• Prognosis
• Hemangiosarcoma/pathology
• Neoplasm Recurrence, Local
• Class I Phosphatidylinositol 3-Kinases
• Neoplasm Grading

• P30 CA008748 NCI NIH HHS
• P50 CA140146 NCI NIH HHS
• P50 CA217694 NCI NIH HHS

• Breast angiosarcoma
• Breast cancer
• Multi-modal breast imaging
• Primary breast angiosarcoma
• Secondary breast angiosarcoma

• Gene Expression Omnibus (GEO)
• breast cancer
• differentially expressed genes
• primary breast angiosarcoma
• transcriptomic studies
• vascular neoplasm

• Female
• Humans
• Middle Aged
• Hemangiosarcoma/diagnosis
• Transcriptome
• Breast Neoplasms/pathology
• Gene Expression Profiling

• angiosarcoma
• breast
• case report
• hypofibrinogenemia
• review of the literature

Vascular lesions of the breast comprise a heterogeneous group that includes a variety of benign, atypical, and malignant lesions. These are a diagnostic challenge given variable clinical, radiological and pathological presentation, especially when they are small and asymptomatic. We present 2 cases of these rare lesions of the breast which were occult to mammographics and ultrasound studies. Both the lesions were detected only on magnetic resonance imaging, most helpful in the diagnosis of these rare tumor. Histopathological examinations following the magnetic resonance guided biopsies, were initially interpreted as negative for breast cancer in both cases. These turned out to be respectively a low grade angiosarcoma and a benign vascular lesion after a new histopathological examination following a larger magnetic resonance guided biopsies performed in light of the radiology-pathology discordance. Although rare, it is important to consider vascular tumours of the breast; radiologists need to be aware such tumors may present non-specific imaging features.

• angiosarcoma
• slnb
• sarcoma
• nodal staging

• Aged
• Breast Neoplasms/pathology
• Breast Neoplasms/surgery
• Female
• Hemangiosarcoma/pathology
• Hemangiosarcoma/surgery
• Humans
• Lymph Node Excision
• Lymph Nodes/pathology
• Lymph Nodes/surgery
• Neoplasm Staging
• Prospective Studies
• Sentinel Lymph Node Biopsy

• P30 CA016086 NCI NIH HHS
• P50 CA058223 NCI NIH HHS

Angiosarcoma is a rare malignant vascular tumor, and the management and outcome of this disease are not well-described. The aim of this study was to report the incidence, patient demographics, and outcomes of angiosarcoma based on national data.

Data on patients with angiosarcoma were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Inverse probability treatment weights (IPTW) were used to assess the survival benefit of operation with additional chemo or radiation therapy compared to operation alone. These variables were further compared against patients who did not receive an operation despite being initially offered one. Cox regression was used to assess survival. Statistical analyses were performed on RStudio.

For this study, 5,135 patients (46% men; median age 69, range 0–102) with angiosarcoma were identified in the SEER database between 1975 and 2016. The age-adjusted incidence rate was 1–4%. Patients were mostly non-Hispanic Caucasian (75.4%). The average tumor size was 4.7 cm, range (.1–98.9). Tumor grades were high at presentation (Grade III 17.2, Grade IV 19, and unknown 50.6%), but half were considered localized tumors. Most patients underwent an operation (66.1%). In 5.6% of patients, the operation was recommended but not performed. The overall 5-year survival was 26.7% (95% CI 25.4–28.1%). IPTW with adjusted Cox proportional hazard model demonstrated worse survival, showing that operation compared to no operation and operation with chemo/radiation compared to operation alone had worse survival between months 0 and 25 but had improved survival after month 25.

The incidence of angiosarcoma is low and long-term survival is poor. Multimodal therapy in the form of neoadjuvant or adjuvant chemo/radiation therapy offers significant long-term survival benefits over operation alone.

• Breast
• High-grade spindle cells
• MED12
• Malignant phyllodes tumor
• Metaplastic breast carcinoma
• Primary breast sarcomas

• Breast/pathology
• Breast Neoplasms/diagnosis
• Breast Neoplasms/genetics
• Carcinoma/diagnosis
• Carcinoma/genetics
• Female
• Humans
• Immunohistochemistry
• Phyllodes Tumor/diagnosis
• Phyllodes Tumor/genetics

• Magnetic resonance imaging
• breast
• computed tomography
• primary neoplasms
• radiation effects
• radiation therapy/oncology

• Aged
• Biopsy
• Breast Neoplasms/diagnostic imaging
• Breast Neoplasms/etiology
• Contrast Media
• Female
• Finland
• Hemangiosarcoma/diagnostic imaging
• Hemangiosarcoma/etiology
• Humans
• Image Interpretation, Computer-Assisted
• Magnetic Resonance Imaging
• Neoplasms, Radiation-Induced/diagnostic imaging
• Registries
• Retrospective Studies
• Sensitivity and Specificity
• Tomography, X-Ray Computed

• Angiosarcoma
• Breast
• Clinicopathologic features
• Epithelioid
• Lymphatic differentiation

• Primary breast angiosarcoma
• axillary lymph node metastasis
• computed tomography
• diagnosis
• magnetic resonance imaging
• supraclavicular lymph node metastasis
• ultrasound

Breast malignancy comprises malignant tumors originating from epithelial tissue and breast sarcoma arising from mesodermal tissues. Despite heterogeneity in tumors, most malignant tumors of the breast are composed of a single type of tumor. Here, we report a patient with breast tumor consisting of three different types of malignancies—squamous cell carcinoma, invasive ductal carcinoma, and high-grade breast sarcoma.

• breast malignant tumor
• breast sarcoma
• invasive ductal carcinoma
• squamous cell carcinoma

Sarcoma of the breast is a rare malignancy with heterogeneous histology. Angiosarcoma, including secondary angiosarcoma from previous radiation, is the most common type of sarcoma of the breast. Other types of sarcomas of the breast have limited clinical and survival information.

We obtained clinicopathological data and survival outcomes from the patients with sarcoma of the breast, excluding angiosarcoma, that were registered in the National Cancer Database (NCDB) from 2004 to 2016. The treatment patterns and prognostic factors were analyzed.

A total of 991 patients had sarcoma of the breast other than angiosarcoma. The most common histology was spindle cell sarcoma (13.4%), followed by leiomyosarcoma (11.7%) and giant cell sarcoma (10.1%). Surgical resection was performed in 894 out of 991 patients (90.2%), including R0 resection achieved in 781 (87.4%). The patients who received surgery showed better survival than the patients without surgery regardless of radiation therapy. When radiation was added to the surgical management, the OS (overall survival) benefit was marginally significant (hazard ratio 1.30 (CI 1.01–1.67), p=0.044). Adding chemotherapy did not improve OS.

Surgical resection seems to be the most important treatment modality in sarcoma of the breast from the analysis of a large database. Radiation therapy added a minor survival benefit to the patients who received surgical resection. Systemic chemotherapy did not play a clear role in sarcoma of the breast.

• blood lakes
• cd31
• cd34
• cutaneous angiosarcoma
• factor viii
• mastectomy
• primary mammary angiosarcoma
• wide local excision

• breast cancer
• plastic and reconstructive surgery
• surgical oncology
• transplantation

• Breast
• primary angiosarcoma
• radiotherapy
• surgery

• Angiosarcoma
• Breast
• Recurrence
• Surgery

• Cutaneous angiosarcoma
• Electrochemotherapy
• Skin metastases
• Skin-directed therapies
• Tumour control

Primary and secondary breast angiosarcoma is a rare and aggressive malignancy with limited published literature. Optimal management is mostly based on expert opinion. Our study aims to describe a single institution experience with breast angiosarcoma and evaluate other publications on this topic to further clarify prognostic outcomes and treatment modalities in this disease.

Twenty two cases of breast angiosarcoma from Roswell Park Comprehensive Cancer Center were retrospectively analyzed. Additionally, a systemic review and meta-analysis was conducted to study the association between survival outcomes, overall survival (OS), and recurrence-free survival (RFS) in both primary (PAS) and secondary breast angiosarcoma (SAS).

9 PAS patients (41%) and 13 SAS patients (59%) were retrospectively analyzed. No significant differences were noted in tumor characteristics and survival outcomes between PAS and SAS. Treatment modality had no significant effects on survival outcomes although adjuvant chemotherapy demonstrated a trend towards improved RFS in high grade tumors. 380 PAS and 595 SAS patients were included in the outcome meta-analysis. Survival outcomes were significantly worse with high grade tumors and tumor size of > 5 cm. Adjuvant radiation therapy demonstrated significantly better RFS, while adjuvant chemotherapy had no effect on survival outcomes.

Tumor size and grade seem to be reliable predictors of survival in both PAS and SAS. Mastectomy does not seem to be adding any additional benefit to BCS. Adjuvant radiation therapy showed statistically significant RFS benefit, while adjuvant chemotherapy can be beneficial in high grade tumors.

• Breast angiosarcoma
• Case–control study
• Meta-analysis
• Primary angiosarcoma
• Secondary angiosarcoma
• Stewart–Treves syndrome

Introduction 

Breast sarcomas are tumors of a mesenchymal origin, with an incidence of less than 1% of the total breast tumors. The diagnosis of this disease is a challenge for pathologists, radiologists, and breast surgeons. 

Aim

To describe the diagnostic, therapeutic, and outcomes approach of patients with breast sarcoma treated at the National Cancer Institute (NCI) in Bogota, Colombia. 

Materials and methods

It is a descriptive and retrospective case series study of patients diagnosed with breast sarcoma treated at the NCI during the period between August 1, 2016 and March 30, 2019. 

Results 

We identified 14 patients diagnosed with breast sarcoma, 10 (71.4%) patients with primary breast sarcomas, and four (28.6%) with sarcomas associated with radiotherapy. The most frequent histological subtype in both, primary and secondary sarcomas, was angiosarcoma (n = 5, 35.7%). 100% (n = 14) of patients received surgical management as primary treatment. Eight (57.1%) patients presented recurrence (disease-free survival (DFS) follow-up of 5.95 months). A total of five deaths were recorded, representing 35.7% of patients (overall survival (OS) follow-up of 23.5 months).

Conclusion

Breast sarcomas are characterized by aggressive clinical behavior, which is why it is important to make a precise histological diagnosis and thus provide patients with radical surgical procedures that ensure local control of the disease and improve DFS. 

• breast neoplasm
• chemotherapy
• radiotherapy
• sarcoma
• surgery

• Chemotherapy
• Localized breast angiosarcoma
• Lumpectomy
• Mastectomy
• National cancer database
• Radiation therapy

• Adult
• Aged
• Aged, 80 and over
• Breast Neoplasms/drug therapy
• Breast Neoplasms/pathology
• Breast Neoplasms/surgery
• Chemotherapy, Adjuvant/methods
• Combined Modality Therapy/methods
• Disease-Free Survival
• Female
• Hemangiosarcoma/drug therapy
• Hemangiosarcoma/pathology
• Hemangiosarcoma/surgery
• Humans
• Mastectomy
• Mastectomy, Segmental
• Middle Aged
• Neoplasm Recurrence, Local/pathology
• Neoplasm Recurrence, Local/surgery
• Quality of Life
• Radiotherapy, Adjuvant/methods

• Angiosarcoma
• primary angiosarcoma
• radiation therapy
• secondary angiosarcoma

Patients with metastatic angiosarcoma undergoing chemotherapy, radiation, and/or surgery experience a median progression free survival of less than 6 months and a median overall survival of less than 12 months. Given the aggressive nature of this cancer, angiosarcoma clinical responses to chemotherapy or targeted therapeutics are generally very poor. Inhibition of beta adrenergic receptor (β-AR) signaling has recently been shown to decrease angiosarcoma tumor cell viability, abrogate tumor growth in mouse models, and decrease proliferation rates in preclinical and clinical settings. In the current study we used cell and animal tumor models to show that β-AR antagonism abrogates mitogenic signaling and reduces angiosarcoma tumor cell viability, and these molecular alterations translated into patient tumors. We demonstrated that non-selective β-AR antagonists are superior to selective β-AR antagonists at inhibiting angiosarcoma cell viability. A prospective analysis of non- selective β-AR antagonists in a single arm clinical study of metastatic angiosarcoma patients revealed that incorporation of either propranolol or carvedilol into patients' treatment regimens leads to a median progression free and overall survival of 9 and 36 months, respectively. These data suggest that incorporation of non-selective β-AR antagonists into existing therapies against metastatic angiosarcoma can enhance clinical outcomes.

• angiosarcoma
• beta blocker
• propranolol
• sarcoma

• Cancer syndrome
• Endometrial cancer
• HNPCC
• Ovarian cancer
• Synchronous cancer
• Young women

• Female
• Humans
• Middle Aged
• Biomarkers
• Breast Neoplasms/diagnosis
• Breast Neoplasms/epidemiology
• Breast Neoplasms/etiology
• Breast Neoplasms/therapy
• Combined Modality Therapy
• Hemangiosarcoma/diagnosis
• Hemangiosarcoma/epidemiology
• Hemangiosarcoma/etiology
• Hemangiosarcoma/therapy
• Immunohistochemistry
• Neoplasm Grading
• Neoplasms, Second Primary/diagnosis
• Neoplasms, Second Primary/epidemiology
• Neoplasms, Second Primary/etiology
• Neoplasms, Second Primary/therapy
• Radiotherapy, Adjuvant/adverse effects
• Radiotherapy, Adjuvant/methods

• Breast cancer
• angiosarcoma
• sarcoma of the chest wall
• soft tissue sarcoma
• treatment

• angiosarcoma
• breast
• radiation-associated sarcoma

• Breast
• Immunoprofile
• Primary angiosarcoma