Key result
Secondary breast angiosarcoma incidence increased ~3-fold among prior breast cancer patients between 1992 and 2016.
Why the study?
Angiosarcoma is a rare complication of breast-conserving therapy, prompting evaluation of the change in incidence of secondary breast angiosarcoma between 1992 and 2016 and how primary breast cancer management affected its treatment.
Observational (n=193)
Yes
Effect estimate: 3-fold increase
Absolute Event Rate: 30% vs 10%
p-value: p=0.0037
The incidence of secondary breast angiosarcoma after breast cancer has increased 3-fold between 1992 and 2016, highlighting a rare but increasing complication.
Supports clinician awareness of rising rates in survivors; leaves open etiology and prevention needs.
OBJECTIVES: Angiosarcoma is a rare complication of breast-conserving therapy. This study evaluated the change in incidence between 1992 and 2016 of secondary breast angiosarcoma (SBA) in patients with a history of breast cancer and the impact of management strategies for the original breast carcinoma on angiosarcoma treatment. METHODS: Breast cancer and angiosarcoma cases were abstracted from the Surveillance, Epidemiology, and End Result (SEER) database. SBAs were defined as angiosarcomas located in the breast occurring after a prior breast cancer diagnosis. Primary breast angiosarcomas (PBAs) were defined as an angiosarcoma diagnosis listed as "one primary only." Incidence rates were estimated using a proportion of the US total population. Survival was analyzed by the Kaplan-Meier method, and Cox proportional hazard models were used to assess the association of clinicopathologic characteristics on overall survival. RESULTS: Between 1992 and 2016, 193 cases of SBA were reported in the SEER dataset in patients with a prior history of breast cancer. The incidence of breast angiosarcoma in patients with a prior diagnosis of breast cancer increased 3-fold from about 10 cases per 100,000 person-years to about 30 cases per 100,000 person-years over this same period ( P =0.0037). For treatment of SBA (n=193), almost all (95%) had surgery. Nine percent received radiation (compared with 35% of patients with PBA, P <0.001) and 23% received chemotherapy (vs. 45% for PBA, P =0.11). CONCLUSIONS: We demonstrate an increasing incidence of SBA over the study period. These data can help inform shared decision-making for optimal management of locoregional breast cancer and raise awareness of secondary angiosarcoma.
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Chau et al. (2023) conducted an observational in Secondary breast angiosarcoma (n=193). Prior diagnosis of breast cancer vs. Baseline year (1992) and Primary breast angiosarcoma was evaluated on Incidence of secondary breast angiosarcoma (3-fold increase, p=0.0037). The incidence of secondary breast angiosarcoma in patients with prior breast cancer increased 3-fold from about 10 to 30 cases per 100,000 person-years between 1992 and 2016 (P=0.0037).
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