Background: 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.
Methods: 22 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).
Results: 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 >5cm. Adjuvant radiation therapy demonstrated significantly better RFS, while adjuvant chemotherapy had no effect on survival outcomes.
Conclusion: 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.
Dr. Yara Abdou was born in Dubai, United Arab Emirates. She obtained her medical degree from Jordan University and then finished a year of research fellowship at the Mayo Clinic, Rochester, MN, USA. Her internal medicine residency was completed at University of New Mexico, Albuquerque, USA. She completed her hematology and oncology fellowship at Roswell Park Comprehensive Cancer Center, affiliated with the University of Buffalo, USA. She is transitioning to a breast medical oncology faculty position in 2020.
Dr. Abdou’s research interests mainly involve studying the tumor microenvironment and ways of modulating immune responses to enhance immunotherapy in breast cancer patients. She has also been recently focusing on studying the tumor microenvironment in African American women and exploring how their immune responses may be contributing to breast cancer racial disparities.