Characteristics and Long-Term Risk of Breast Angiosarcoma

Annals of Surgical Oncology (2021)Cite this article

Abstract

Background

Angiosarcoma of the breast is rare and aggressive. It can occur as a de novo tumor or secondary to breast cancer treatment. The purpose of this study is to analyze differences between patients with primary and secondary angiosarcoma of the breast and investigate potential risk factors for its development.

Patients and Methods

The Surveillance, Epidemiology, and End Results program of the National Cancer Institute database was queried to identify patients with angiosarcoma of the breast, trunk, shoulder, and upper arm. The population-based incidence was analyzed. Primary and secondary angiosarcoma cases were identified and compared. Breast cancer characteristics of secondary angiosarcoma patients were compared with all breast cancer patients in the database who did not develop angiosarcoma.

Results

Overall, 904 patients were included, and 65.4% were secondary angiosarcomas. These patients had worse survival, were older, more likely to be White, more likely to have regionally advanced disease, and had angiosarcoma tumors of higher pathologic grade. Independent factors associated with development of secondary angiosarcoma among breast cancer patients included White race, older age, invasive tumor, lymph node removal, lumpectomy, radiation treatment, and left-sided tumor. Although the mean time to develop angiosarcoma after breast cancer diagnosis was 8.2 years, the risk continues to increase up to 30 years after breast cancer treatment.

Conclusion

Angiosarcoma is rare but increasing in incidence. Secondary angiosarcomas are more common and exhibit more aggressive behavior. Several factors for angiosarcoma after breast cancer treatment could be identified, which may help us counsel and identify patients at risk.

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Affiliations

  1. Department of Surgery, Yale University School of Medicine, New Haven, CT, 06520, USA

    Ann-Kristin U. Friedrich MD, Danielle R. Heller MD, Justin M. LeBlanc MD, Tristen S. Park MD & Donald R. Lannin MD

  2. Departments of Pathology and Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, 06520, USA

    Emily S. Reisenbichler MD

  3. St. Vincent’s Medical Center, Hartford HealthCare, Bridgeport, CT , USA

    Brigid K. Killelea MD, MPH

Authors
  1. Ann-Kristin U. Friedrich MD
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  2. Emily S. Reisenbichler MD
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  3. Danielle R. Heller MD
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  4. Justin M. LeBlanc MD
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  5. Tristen S. Park MD
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  6. Brigid K. Killelea MD, MPH
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  7. Donald R. Lannin MD
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Correspondence to Donald R. Lannin MD.

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Brigid Killelea—Consultant for Genetech.

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Friedrich, AK.U., Reisenbichler, E.S., Heller, D.R. et al. Characteristics and Long-Term Risk of Breast Angiosarcoma. Ann Surg Oncol (2021). https://doi.org/10.1245/s10434-021-09689-2

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