Angiosarcoma is a rare late effect of radiotherapy following early breast cancer treatment. This study looked at the management and outcomes for radiation associated angiosarcoma at our Cancer centre serving a population of 2.5 million
All patients diagnosed with breast angiosarcoma from Jan 1997- March 2016 were identified from electronic medical records. 41patients were identified. 5 patients had primary angiosarcoma and were excluded. 36 had prior adjuvant radiotherapy for breast cancer and formed the study cohort. All patients were discussed by the central Sarcoma multidisciplinary team for pathology review and management planning. Patient demographics, breast cancer treatment, radiotherapy details, date of diagnosis of radiation associated angiosarcoma(RAS) and surgical treatment details and pathological parameters of RAS including grade, size and margin information was collated. Date of recurrence and date of death were collected. Excel spreadsheet and SPSS were used to analyse the data.
Median follow up was 5 years (Range 0.2-18 years). Median age at diagnosis was 70 years (Range 37-85). 32 patients had wide excision and 4 mastectomy for breast cancer. All had whole breast radiotherapy -40 Gray in 15 fractions and 7 had additional breast boost radiation to tumour bed. Median time from radiotherapy to developing angiosarcoma was 7 years (Range 2 - 17). 32 patients had surgery for RAS with radical intent. 18 had clear (>10mm) and 10 patients had close margins(
RAS is a very rare late effect of radiation therapy with only 36 cases found over 20 years within a large population of 2.5 million. Latency for RAS can be shorter in some cases than widely recognised. It has a poor prognosis with median survival less than 3 years. Early detection and radical surgery with wide margins gives the best outcome.
Clinical trial identification
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All authors have declared no conflicts of interest.