Primary angiosarcomas of the breast

Taimur Sher, Bryan T. Hennessy, Vicente Valero, Krisitine Broglio, Wendy A. Woodward, Jonathan Trent, Kelly K. Hunt, Gabriel N. Hortobagyi, Ana M. Gonzalez-Angulo

Research output: Contribution to journalArticle

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Abstract

BACKGROUND. The purpose of the study was to describe the clinicopathologic characteristics and clinical outcomes of patients with primary breast angiosarcoma. METHODS. The institutional database was searched to identify breast angiosarcoma patients seen between 1965 and 2002. Survival outcomes were estimated by the Kaplan-Meier method. The log-rank test was used to compare groups. Cox proportional hazards models were used for multivariate analysis. RESULTS. In all, 69 patients were identified. Median follow-up was 40 months (range, 0-413 months). Median age was 46. Median tumor size at diagnosis was 5.5 cm. Thirteen (18.8%) patients received prior radiation for invasive breast carcinoma. Most patients underwent total mastectomy with (41%) or without (45%) axillary dissection. Regional metastasis to axillary lymph nodes was rare. There were 38 recurrences and 27 deaths. The 5-year overall (OS) and recurrence-free survival (RFS) rates were 61% (95% confidence interval [CI], 49%-76%) and 44% (95% CI, 33%-58%) with estimated medians of 100 and 37 months, respectively. In Cox proportional hazards models, OS and RFS were significantly associated only with T size and not with patient age, prior radiation, or chemotherapy administration. Of 29 patients treated with chemotherapy at recurrence, there were 4 complete and 10 partial responses (48%) with an anthracycline-ifosfamide or gemcitabine-taxane combination. CONCLUSIONS. Breast angiosarcoma is frequently advanced at diagnosis and has a tendency for local-regional recurrence. A significant number of responses to chemotherapy was observed in the metastatic setting. These data suggest that a multidisciplinary therapeutic approach should be employed in high-risk patients with large primary tumors.

Original languageEnglish (US)
Pages (from-to)173-178
Number of pages6
JournalCancer
Volume110
Issue number1
DOIs
StatePublished - Jul 1 2007
Externally publishedYes

Fingerprint

Recurrence
gemcitabine
Proportional Hazards Models
Drug Therapy
Simple Mastectomy
Confidence Intervals
Radiation
Ifosfamide
Survival
Angiosarcoma of the breast
Anthracyclines
Dissection
Neoplasms
Multivariate Analysis
Survival Rate
Lymph Nodes
Databases
Breast Neoplasms
Neoplasm Metastasis
Therapeutics

Keywords

  • Angiosarcoma
  • Breast cancer
  • Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Sher, T., Hennessy, B. T., Valero, V., Broglio, K., Woodward, W. A., Trent, J., ... Gonzalez-Angulo, A. M. (2007). Primary angiosarcomas of the breast. Cancer, 110(1), 173-178. https://doi.org/10.1002/cncr.22784

Primary angiosarcomas of the breast. / Sher, Taimur; Hennessy, Bryan T.; Valero, Vicente; Broglio, Krisitine; Woodward, Wendy A.; Trent, Jonathan; Hunt, Kelly K.; Hortobagyi, Gabriel N.; Gonzalez-Angulo, Ana M.

In: Cancer, Vol. 110, No. 1, 01.07.2007, p. 173-178.

Research output: Contribution to journalArticle

Sher, T, Hennessy, BT, Valero, V, Broglio, K, Woodward, WA, Trent, J, Hunt, KK, Hortobagyi, GN & Gonzalez-Angulo, AM 2007, 'Primary angiosarcomas of the breast', Cancer, vol. 110, no. 1, pp. 173-178. https://doi.org/10.1002/cncr.22784
Sher T, Hennessy BT, Valero V, Broglio K, Woodward WA, Trent J et al. Primary angiosarcomas of the breast. Cancer. 2007 Jul 1;110(1):173-178. https://doi.org/10.1002/cncr.22784
Sher, Taimur ; Hennessy, Bryan T. ; Valero, Vicente ; Broglio, Krisitine ; Woodward, Wendy A. ; Trent, Jonathan ; Hunt, Kelly K. ; Hortobagyi, Gabriel N. ; Gonzalez-Angulo, Ana M. / Primary angiosarcomas of the breast. In: Cancer. 2007 ; Vol. 110, No. 1. pp. 173-178.
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N2 - BACKGROUND. The purpose of the study was to describe the clinicopathologic characteristics and clinical outcomes of patients with primary breast angiosarcoma. METHODS. The institutional database was searched to identify breast angiosarcoma patients seen between 1965 and 2002. Survival outcomes were estimated by the Kaplan-Meier method. The log-rank test was used to compare groups. Cox proportional hazards models were used for multivariate analysis. RESULTS. In all, 69 patients were identified. Median follow-up was 40 months (range, 0-413 months). Median age was 46. Median tumor size at diagnosis was 5.5 cm. Thirteen (18.8%) patients received prior radiation for invasive breast carcinoma. Most patients underwent total mastectomy with (41%) or without (45%) axillary dissection. Regional metastasis to axillary lymph nodes was rare. There were 38 recurrences and 27 deaths. The 5-year overall (OS) and recurrence-free survival (RFS) rates were 61% (95% confidence interval [CI], 49%-76%) and 44% (95% CI, 33%-58%) with estimated medians of 100 and 37 months, respectively. In Cox proportional hazards models, OS and RFS were significantly associated only with T size and not with patient age, prior radiation, or chemotherapy administration. Of 29 patients treated with chemotherapy at recurrence, there were 4 complete and 10 partial responses (48%) with an anthracycline-ifosfamide or gemcitabine-taxane combination. CONCLUSIONS. Breast angiosarcoma is frequently advanced at diagnosis and has a tendency for local-regional recurrence. A significant number of responses to chemotherapy was observed in the metastatic setting. These data suggest that a multidisciplinary therapeutic approach should be employed in high-risk patients with large primary tumors.

AB - BACKGROUND. The purpose of the study was to describe the clinicopathologic characteristics and clinical outcomes of patients with primary breast angiosarcoma. METHODS. The institutional database was searched to identify breast angiosarcoma patients seen between 1965 and 2002. Survival outcomes were estimated by the Kaplan-Meier method. The log-rank test was used to compare groups. Cox proportional hazards models were used for multivariate analysis. RESULTS. In all, 69 patients were identified. Median follow-up was 40 months (range, 0-413 months). Median age was 46. Median tumor size at diagnosis was 5.5 cm. Thirteen (18.8%) patients received prior radiation for invasive breast carcinoma. Most patients underwent total mastectomy with (41%) or without (45%) axillary dissection. Regional metastasis to axillary lymph nodes was rare. There were 38 recurrences and 27 deaths. The 5-year overall (OS) and recurrence-free survival (RFS) rates were 61% (95% confidence interval [CI], 49%-76%) and 44% (95% CI, 33%-58%) with estimated medians of 100 and 37 months, respectively. In Cox proportional hazards models, OS and RFS were significantly associated only with T size and not with patient age, prior radiation, or chemotherapy administration. Of 29 patients treated with chemotherapy at recurrence, there were 4 complete and 10 partial responses (48%) with an anthracycline-ifosfamide or gemcitabine-taxane combination. CONCLUSIONS. Breast angiosarcoma is frequently advanced at diagnosis and has a tendency for local-regional recurrence. A significant number of responses to chemotherapy was observed in the metastatic setting. These data suggest that a multidisciplinary therapeutic approach should be employed in high-risk patients with large primary tumors.

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