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- Title
Radiation-induced angiosarcoma and atypical vascular lesion of the breast: Case report and narrative meta-analysis of observational studies.
- Authors
Berg, Kyra B.; Chiu, Kenrry; Wright, Joanne L.; Warburton, Rebecca; Myles, Nickolas
- Abstract
Objectives: Angiosarcoma is a rare complication of radiation therapy (RT) for breast cancer. Knowledge of its clinical epidemiology is useful for multi-disciplinary breast teams, but not readily available. Aims: To present a case of radiation-induced angiosarcoma and synthesize evidence on incidence, relative risk (RR), number needed to harm (NNH), and prognosis of radiation-induced angiosarcomas and atypical vascular lesions (AVL) of the breast. Methods: A 10-year systematic evidence search using DynaMed and MEDLINE databases. Data and results: We present a case of breast angiosarcoma and background AVL in a 77-year old woman 12 years after RT for invasive lobular carcinoma, with no evidence of recurrent breast malignancy. The evidence search identified 119 references; 8 contained extractable information (evidence levels 3-5, Oxford system). Radiation-Induced Angiosarcoma: The RR is 3.12-6.12 and NNH of 1525-3276 (2 studies); median latency of 7-7.3 years. The prevalence is 36/1000 (compared to 6/1000 for primary breast angiosarcoma, 1 study). The median survival for is 35-49 months (5-year survival 38-54%; 4 studies), similar to 48 months for primary angiosarcoma (5-year survival 46%, 1 study). Atypical vascular lesions: In one study of 30 patients diagnosed with AVL, 2 patients (6.7%) developed angiosarcoma; median latency 48.5 months, prevalence unknown. Conclusions: RT for breast cancer carries at least triple RR of angiosarcoma, but minimally increased absolute risk (less than one in 1500). The prognosis of radiation-induced breast angiosarcoma is not different from primary breast angiosarcoma.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, p30
- ISSN
1918-915X
- Publication type
Article