Skip to main content

23.03.2024 | Review

Radiation-Induced Breast Angiosarcoma: Updates on a Rare Disease

verfasst von: Katherine M. Jackson, Janie G. Grumley

Erschienen in: Current Breast Cancer Reports

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Although rare, breast angiosarcoma imparts poor outcomes relative to other breast malignancies. Here, we review the current literature focusing on radiation-induced angiosarcoma of the breast (RIA), a subset of secondary breast angiosarcoma.

Recent Findings

The risk of developing RIA increases with time after radiation therapy, and incidence is expected to increase. Cross-sectional imaging with MRI or CT has a higher sensitivity for RIA detection than ultrasound and mammography studies. The clinical outcomes of RIA are improving with the use of wide resections and systemic chemotherapy, with up to an 85% 5-year overall survival in surgically resected patients. Multidisciplinary team engagement improves access to emerging therapies and correlates with increased survival.

Summary

Improvements in diagnostic techniques, multidisciplinary care, and inclusion of modern systemic therapies in treatment of RIA may be responsible for improved survival. Future studies focusing on systemic treatment and access to sarcoma expertise may play a further impact survival for this rare disease.
Literatur
1.
Zurück zum Zitat Yap J, Chuba PJ, Thomas R, et al. Sarcoma as a second malignancy after treatment for breast cancer. Int J Radiat Oncol Biol Phys. 2002;52(5):1231–7.CrossRefPubMed Yap J, Chuba PJ, Thomas R, et al. Sarcoma as a second malignancy after treatment for breast cancer. Int J Radiat Oncol Biol Phys. 2002;52(5):1231–7.CrossRefPubMed
2.
Zurück zum Zitat Conti M, Morciano F, Rossati C, Gori E, Belli P, Fornasa F, Romanucci G, Rella R. Angiosarcoma of the breast: overview of current data and multimodal imaging findings. J Imaging. 2023;9(5):94.CrossRefPubMedPubMedCentral Conti M, Morciano F, Rossati C, Gori E, Belli P, Fornasa F, Romanucci G, Rella R. Angiosarcoma of the breast: overview of current data and multimodal imaging findings. J Imaging. 2023;9(5):94.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Bentley H, Roberts J, Hayes M, et al. The role of imaging in the diagnosis of primary and secondary breast angiosarcoma: twenty-five-year experience of a provincial cancer institution. Clin Breast Cancer. 2023;23(2):e45–53.CrossRefPubMed Bentley H, Roberts J, Hayes M, et al. The role of imaging in the diagnosis of primary and secondary breast angiosarcoma: twenty-five-year experience of a provincial cancer institution. Clin Breast Cancer. 2023;23(2):e45–53.CrossRefPubMed
4.
Zurück zum Zitat Verdin V, Mattart L, Cusumano PG, et al. Angiosarcoma associated with radiation therapy after treatment of breast cancer. Retrospective study on ten years. Cancer Radiother. 2021;25(2):114–8.CrossRefPubMed Verdin V, Mattart L, Cusumano PG, et al. Angiosarcoma associated with radiation therapy after treatment of breast cancer. Retrospective study on ten years. Cancer Radiother. 2021;25(2):114–8.CrossRefPubMed
5.
Zurück zum Zitat • Friedrich AU, Reisenbichler ES, Heller DR, et al. Characteristics and long-term risk of breast angiosarcoma. Ann Surg Oncol. 2021;28(9):5112–8. Friedrich et al. reports a large study utilizing the Surveillance, Epidemiology, and End Results (SEER) database examining risk factors associated with the development of radiation induced angiosarcoma. • Friedrich AU, Reisenbichler ES, Heller DR, et al. Characteristics and long-term risk of breast angiosarcoma. Ann Surg Oncol. 2021;28(9):5112–8. Friedrich et al. reports a large study utilizing the Surveillance, Epidemiology, and End Results (SEER) database examining risk factors associated with the development of radiation induced angiosarcoma.
6.
Zurück zum Zitat Bryant AK, Banegas MP, Martinez ME, Mell LK, Murphy JD. Trends in radiation therapy among cancer survivors in the United States, 2000–2030. Cancer Epidemiol Biomarkers Prev. 2017;26(6):963–70.CrossRefPubMed Bryant AK, Banegas MP, Martinez ME, Mell LK, Murphy JD. Trends in radiation therapy among cancer survivors in the United States, 2000–2030. Cancer Epidemiol Biomarkers Prev. 2017;26(6):963–70.CrossRefPubMed
7.
Zurück zum Zitat de Boniface J, Szulkin R, Johansson ALV. Survival after breast conservation vs mastectomy adjusted for comorbidity and socioeconomic status: a Swedish national 6-year follow-up of 48 986 women. JAMA Surg. 2021;156(7):628–37.CrossRefPubMedPubMedCentral de Boniface J, Szulkin R, Johansson ALV. Survival after breast conservation vs mastectomy adjusted for comorbidity and socioeconomic status: a Swedish national 6-year follow-up of 48 986 women. JAMA Surg. 2021;156(7):628–37.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Alves I, Marques JC. Radiation-induced angiosarcoma of the breast: a retrospective analysis of 15 years’ experience at an oncology center. Radiol Bras. 2018;51(5):281–6.CrossRefPubMedPubMedCentral Alves I, Marques JC. Radiation-induced angiosarcoma of the breast: a retrospective analysis of 15 years’ experience at an oncology center. Radiol Bras. 2018;51(5):281–6.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Mito JK, Mitra D, Barysauskas CM, et al. A comparison of outcomes and prognostic features for radiation-associated angiosarcoma of the breast and other radiation-associated sarcomas. Int J Radiat Oncol Biol Phys. 2019;104(2):425–35.CrossRefPubMed Mito JK, Mitra D, Barysauskas CM, et al. A comparison of outcomes and prognostic features for radiation-associated angiosarcoma of the breast and other radiation-associated sarcomas. Int J Radiat Oncol Biol Phys. 2019;104(2):425–35.CrossRefPubMed
10.
Zurück zum Zitat Rombouts AJM, Huising J, Hugen N, et al. Assessment of radiotherapy-associated angiosarcoma after breast cancer treatment in a Dutch population-based study. JAMA Oncol. 2019;5(2):267–9.CrossRefPubMedPubMedCentral Rombouts AJM, Huising J, Hugen N, et al. Assessment of radiotherapy-associated angiosarcoma after breast cancer treatment in a Dutch population-based study. JAMA Oncol. 2019;5(2):267–9.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Gutkin PM, Ganjoo KN, Lohman M, et al. Angiosarcoma of the breast: management and outcomes. Am J Clin Oncol. 2020;43(11):820–5.CrossRefPubMed Gutkin PM, Ganjoo KN, Lohman M, et al. Angiosarcoma of the breast: management and outcomes. Am J Clin Oncol. 2020;43(11):820–5.CrossRefPubMed
12.
Zurück zum Zitat Rummel KA, Gao RW, Francis LN, Petersen IA, Mutter RW, Corbin KS. Secondary breast angiosarcoma following accelerated partial breast irradiation with intracavitary multicatheter applicator brachytherapy. Brachytherapy. 2023;22(4):487–90.CrossRefPubMed Rummel KA, Gao RW, Francis LN, Petersen IA, Mutter RW, Corbin KS. Secondary breast angiosarcoma following accelerated partial breast irradiation with intracavitary multicatheter applicator brachytherapy. Brachytherapy. 2023;22(4):487–90.CrossRefPubMed
13.
Zurück zum Zitat Takehara Y, Matsuda N, Kobayashi D, et al. Radiation-induced angiosarcoma of the breast: individual participant meta-analysis of Japanese population. Breast Cancer. 2023;30(5):739–47.CrossRefPubMed Takehara Y, Matsuda N, Kobayashi D, et al. Radiation-induced angiosarcoma of the breast: individual participant meta-analysis of Japanese population. Breast Cancer. 2023;30(5):739–47.CrossRefPubMed
14.
Zurück zum Zitat Banks J, George J, Potter S, et al. Breast Angiosarcoma Surveillance Study: UK national audit of management and outcomes of angiosarcoma of the breast and chest wall. Br J Surg. 2021;108(4):388–94.CrossRefPubMed Banks J, George J, Potter S, et al. Breast Angiosarcoma Surveillance Study: UK national audit of management and outcomes of angiosarcoma of the breast and chest wall. Br J Surg. 2021;108(4):388–94.CrossRefPubMed
15.
Zurück zum Zitat Yan M, Gilmore H, Bomeisl P, Harbhajanka A. Clinicopathologic and immunohistochemical study of breast angiosarcoma. Ann Diagn Pathol. 2021;54: 151795.CrossRefPubMed Yan M, Gilmore H, Bomeisl P, Harbhajanka A. Clinicopathologic and immunohistochemical study of breast angiosarcoma. Ann Diagn Pathol. 2021;54: 151795.CrossRefPubMed
16.
Zurück zum Zitat Li GZ, Fairweather M, Wang J, Orgill DP, Bertagnolli MM, Raut CP. Cutaneous radiation-associated breast angiosarcoma: radicality of surgery impacts survival. Ann Surg. 2017;265(4):814–20.CrossRefPubMed Li GZ, Fairweather M, Wang J, Orgill DP, Bertagnolli MM, Raut CP. Cutaneous radiation-associated breast angiosarcoma: radicality of surgery impacts survival. Ann Surg. 2017;265(4):814–20.CrossRefPubMed
17.
Zurück zum Zitat Brenn T, Fletcher CD. Radiation-associated cutaneous atypical vascular lesions and angiosarcoma: clinicopathologic analysis of 42 cases. Am J Surg Pathol. 2005;29(8):983–96.CrossRefPubMed Brenn T, Fletcher CD. Radiation-associated cutaneous atypical vascular lesions and angiosarcoma: clinicopathologic analysis of 42 cases. Am J Surg Pathol. 2005;29(8):983–96.CrossRefPubMed
18.
Zurück zum Zitat Salminen SH, Sampo MM, Bohling TO, et al. Radiation-associated angiosarcoma of the breast: analysis of diagnostic tools in a registry-based population. Acta Radiol. 2022;63(1):22–7.CrossRefPubMed Salminen SH, Sampo MM, Bohling TO, et al. Radiation-associated angiosarcoma of the breast: analysis of diagnostic tools in a registry-based population. Acta Radiol. 2022;63(1):22–7.CrossRefPubMed
19.
Zurück zum Zitat Taffurelli M, Pellegrini A, Meattini I, et al. Secondary breast angiosarcoma: a multicentre retrospective survey by the National Italian Association of Breast Surgeons (ANISC). Breast. 2019;45:56–60.CrossRefPubMed Taffurelli M, Pellegrini A, Meattini I, et al. Secondary breast angiosarcoma: a multicentre retrospective survey by the National Italian Association of Breast Surgeons (ANISC). Breast. 2019;45:56–60.CrossRefPubMed
20.
Zurück zum Zitat Cannella L, Perri F, Clemente O, et al. The complex management of the breast angiosarcoma: a retrospective study. Oncology. 2023;101(4):234–9.CrossRefPubMed Cannella L, Perri F, Clemente O, et al. The complex management of the breast angiosarcoma: a retrospective study. Oncology. 2023;101(4):234–9.CrossRefPubMed
21.
Zurück zum Zitat Salminen SH, Sampo MM, Bohling TO, Tuomikoski L, Tarkkanen M, Blomqvist CP. Radiation-associated sarcoma after breast cancer in a nationwide population: increasing risk of angiosarcoma. Cancer Med. 2018;7(9):4825–35.CrossRefPubMedPubMedCentral Salminen SH, Sampo MM, Bohling TO, Tuomikoski L, Tarkkanen M, Blomqvist CP. Radiation-associated sarcoma after breast cancer in a nationwide population: increasing risk of angiosarcoma. Cancer Med. 2018;7(9):4825–35.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Notter M, Stutz E, Thomsen AR, Vaupel P. Radiation-associated angiosarcoma ofthe breast and chest wall treated with thermography-controlled, contactless wira-hyperthermia and hypofractionated re-irradiation. Cancers (Basel). 2021;13(15):3911.CrossRefPubMedPubMedCentral Notter M, Stutz E, Thomsen AR, Vaupel P. Radiation-associated angiosarcoma ofthe breast and chest wall treated with thermography-controlled, contactless wira-hyperthermia and hypofractionated re-irradiation. Cancers (Basel). 2021;13(15):3911.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Cohen-Hallaleh RB, Smith HG, Smith RC, et al. Radiation induced angiosarcoma of the breast: outcomes from a retrospective case series. Clin Sarcoma Res. 2017;7:15.CrossRefPubMedPubMedCentral Cohen-Hallaleh RB, Smith HG, Smith RC, et al. Radiation induced angiosarcoma of the breast: outcomes from a retrospective case series. Clin Sarcoma Res. 2017;7:15.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat •• Guram S, Covelli AM, O’Neill AC, et al. Multidisciplinary intervention in radiation-associated angiosarcoma of the breast: patterns of recurrence and response to treatment. Ann Surg Oncol. 2022;29(1):522–32. Guram et al. highlights prognostic factors associated with prolonged survival in RIA patients. The authors report survival outcomes for a cohort of patients receiving neoadjuvant chemotherapy, and emphasize the importance of multidisciplinary team involvement in the management of RIA. •• Guram S, Covelli AM, O’Neill AC, et al. Multidisciplinary intervention in radiation-associated angiosarcoma of the breast: patterns of recurrence and response to treatment. Ann Surg Oncol. 2022;29(1):522–32. Guram et al. highlights prognostic factors associated with prolonged survival in RIA patients. The authors report survival outcomes for a cohort of patients receiving neoadjuvant chemotherapy, and emphasize the importance of multidisciplinary team involvement in the management of RIA.
25.
Zurück zum Zitat • Salminen SH, Wiklund T, Sampo MM, et al. Treatment and prognosis of radiation-associated breast angiosarcoma in a nationwide population. Ann Surg Oncol. 2020;27(4):1002–10. Salminen et al report outcomes from their Finnish Cancer Database which details management strategies and outcomes of their cohort of patients with RIA, and includes prognostic factors for survival. • Salminen SH, Wiklund T, Sampo MM, et al. Treatment and prognosis of radiation-associated breast angiosarcoma in a nationwide population. Ann Surg Oncol. 2020;27(4):1002–10. Salminen et al report outcomes from their Finnish Cancer Database which details management strategies and outcomes of their cohort of patients with RIA, and includes prognostic factors for survival.
26.
Zurück zum Zitat Kacen MG, Sangle N, Kornecki A. Contrast-enhanced mammography in the diagnosis of breast angiosarcoma. Case Rep Radiol. 2021;2021:5542786.PubMedPubMedCentral Kacen MG, Sangle N, Kornecki A. Contrast-enhanced mammography in the diagnosis of breast angiosarcoma. Case Rep Radiol. 2021;2021:5542786.PubMedPubMedCentral
27.
Zurück zum Zitat Cassou-Mounat T, Champion L, Bozec L, et al. Primary and secondary breast angiosarcoma: FDG PET/CT series. Clin Nucl Med. 2019;44(1):e33–5.CrossRefPubMed Cassou-Mounat T, Champion L, Bozec L, et al. Primary and secondary breast angiosarcoma: FDG PET/CT series. Clin Nucl Med. 2019;44(1):e33–5.CrossRefPubMed
28.
Zurück zum Zitat Shah S, Rosa M. Radiation-associated angiosarcoma of the breast: clinical and pathologic features. Arch Pathol Lab Med. 2016;140(5):477–81.CrossRefPubMed Shah S, Rosa M. Radiation-associated angiosarcoma of the breast: clinical and pathologic features. Arch Pathol Lab Med. 2016;140(5):477–81.CrossRefPubMed
29.
Zurück zum Zitat Daniels BH, Ko JS, Rowe JJ, Downs-Kelly E, Billings SD. Radiation-associated angiosarcoma in the setting of breast cancer mimicking radiation dermatitis: a diagnostic pitfall. J Cutan Pathol. 2017;44(5):456–61.CrossRefPubMed Daniels BH, Ko JS, Rowe JJ, Downs-Kelly E, Billings SD. Radiation-associated angiosarcoma in the setting of breast cancer mimicking radiation dermatitis: a diagnostic pitfall. J Cutan Pathol. 2017;44(5):456–61.CrossRefPubMed
31.
Zurück zum Zitat Reijers SJM, HuisInt Veld EA, Grunhagen DJ, et al. Prognosis of patients with cutaneous angiosarcoma after surgical resection with curative intent: is there a difference between the subtypes? Ann Surg Oncol. 2023;30(1):493–502.CrossRefPubMed Reijers SJM, HuisInt Veld EA, Grunhagen DJ, et al. Prognosis of patients with cutaneous angiosarcoma after surgical resection with curative intent: is there a difference between the subtypes? Ann Surg Oncol. 2023;30(1):493–502.CrossRefPubMed
32.
Zurück zum Zitat Kronenfeld JP, Crystal JS, Ryon EL, Yadegarynia S, Chitters C, Yechieli R, D’Amato G, Rosenberg AE, Kesmodel SB, Trent JC, Goel N. Clinical outcomes for primary and radiation-associated angiosarcoma of the breast with multimodal treatment: long-term survival Is achievable. Cancers (Basel). 2021;13(15):3814.CrossRefPubMedPubMedCentral Kronenfeld JP, Crystal JS, Ryon EL, Yadegarynia S, Chitters C, Yechieli R, D’Amato G, Rosenberg AE, Kesmodel SB, Trent JC, Goel N. Clinical outcomes for primary and radiation-associated angiosarcoma of the breast with multimodal treatment: long-term survival Is achievable. Cancers (Basel). 2021;13(15):3814.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Herb J, Maduekwe UN, Goel N, Rosenberger LH, Spanheimer PM. Does angiosarcoma of the breast need nodal staging? J Am Coll Surg. 2022;234(5):774–82.CrossRefPubMedPubMedCentral Herb J, Maduekwe UN, Goel N, Rosenberger LH, Spanheimer PM. Does angiosarcoma of the breast need nodal staging? J Am Coll Surg. 2022;234(5):774–82.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Kokkali S, Moreno JD, Klijanienko J, Theocharis S. Clinical and molecular insights of radiation-induced breast sarcomas: is there hope on the horizon for effective treatment of this aggressive disease? Int J Mol Sci. 2022;23(8):4125.CrossRefPubMedPubMedCentral Kokkali S, Moreno JD, Klijanienko J, Theocharis S. Clinical and molecular insights of radiation-induced breast sarcomas: is there hope on the horizon for effective treatment of this aggressive disease? Int J Mol Sci. 2022;23(8):4125.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Florou V, Rosenberg AE, Wieder E, et al. Angiosarcoma patients treated with immune checkpoint inhibitors: a case series of seven patients from a single institution. J Immunother Cancer. 2019;7(1):213.CrossRefPubMedPubMedCentral Florou V, Rosenberg AE, Wieder E, et al. Angiosarcoma patients treated with immune checkpoint inhibitors: a case series of seven patients from a single institution. J Immunother Cancer. 2019;7(1):213.CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Depla AL, Scharloo-Karels CH, de Jong MAA, et al. Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer: a systematic review. Eur J Cancer. 2014;50(10):1779–88.CrossRefPubMed Depla AL, Scharloo-Karels CH, de Jong MAA, et al. Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer: a systematic review. Eur J Cancer. 2014;50(10):1779–88.CrossRefPubMed
37.
Zurück zum Zitat Yin M, Wang W, Drabick JJ, Harold HA. Prognosis and treatment of non-metastatic primary and secondary breast angiosarcoma: a comparative study. BMC Cancer. 2017;17(1):295.CrossRefPubMedPubMedCentral Yin M, Wang W, Drabick JJ, Harold HA. Prognosis and treatment of non-metastatic primary and secondary breast angiosarcoma: a comparative study. BMC Cancer. 2017;17(1):295.CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat Hodgson NC, Bowen-Wells C, Moffat F, Franceschi D, Avisar E. Angiosarcomas of the breast: a review of 70 cases. Am J Clin Oncol. 2007;30(6):570–3.CrossRefPubMed Hodgson NC, Bowen-Wells C, Moffat F, Franceschi D, Avisar E. Angiosarcomas of the breast: a review of 70 cases. Am J Clin Oncol. 2007;30(6):570–3.CrossRefPubMed
39.
Zurück zum Zitat Teng L, Yan S, Du J, Yang R, Xu P, Tao W. Clinicopathological analysis and prognostic treatment study of angiosarcoma of the breast: a SEER population-based analysis. World J Surg Oncol. 2023;21(1):144.CrossRefPubMedPubMedCentral Teng L, Yan S, Du J, Yang R, Xu P, Tao W. Clinicopathological analysis and prognostic treatment study of angiosarcoma of the breast: a SEER population-based analysis. World J Surg Oncol. 2023;21(1):144.CrossRefPubMedPubMedCentral
Metadaten
Titel
Radiation-Induced Breast Angiosarcoma: Updates on a Rare Disease
verfasst von
Katherine M. Jackson
Janie G. Grumley
Publikationsdatum
23.03.2024
Verlag
Springer US
Erschienen in
Current Breast Cancer Reports
Print ISSN: 1943-4588
Elektronische ISSN: 1943-4596
DOI
https://doi.org/10.1007/s12609-024-00542-5

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

15% bedauern gewählte Blasenkrebs-Therapie

29.05.2024 Urothelkarzinom Nachrichten

Ob Patienten und Patientinnen mit neu diagnostiziertem Blasenkrebs ein Jahr später Bedauern über die Therapieentscheidung empfinden, wird einer Studie aus England zufolge von der Radikalität und dem Erfolg des Eingriffs beeinflusst.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.