Key result
Primary breast cancer radiotherapy linked to ~190% higher secondary angiosarcoma risk versus healthy populations.
Why the study?
Patients treated with radiotherapy for primary breast cancer are at higher risk for developing secondary angiosarcoma, but the etiological relationship remains controversial.
Does radiotherapy for primary breast cancer increase the risk of secondary angiosarcoma compared to the healthy population?
Case Report (n=5,100)
No
Does radiotherapy for primary breast cancer increase the risk of secondary angiosarcoma compared to the healthy population?
Odds Ratio: 2.9
Radiotherapy for primary breast cancer is associated with a rare but increased risk of secondary angiosarcoma, for which early radical surgery is the only effective treatment.
Raises awareness for angiosarcoma surveillance in breast radiotherapy survivors; hypothesis-generating and requires prospective validation before practice implications.
The authors report two cases of postradiation angiosarcoma (AS) among 5,100 breast cancer patients treated in the period 1980-1994 at the National Institute of Oncology, Budapest. Relevant data in the literature is also reviewed to analyze the questions of radiogenic origin, diagnosis and treatment. Secondary AS occurred in these cases in a previously irradiated field after a 6- and 8-year latency period, respectively. Detailed histopathological and immunohistochemical examinations from the biopsy specimens confirmed the diagnosis as AS. The first patient was treated successfully with radical surgery. The second patient, with unresectable AS, died of rapid local progression within 4 months. The incidence of chest wall and breast AS after radiotherapy was found to be 0.46 per 1,000 in our patient population, which means an estimated odds ratio of 2.9 for secondary AS. Patients treated with radiotherapy for primary breast cancer are at higher risk for developing secondary AS compared to the healthy population. An etiological relationship between radiotherapy and subsequent AS of the chest wall and breast is likely, but still controversial. Initial radical surgery is the only effective treatment for achieving long-term survival. These very rare cases deserve special attention due to the atypical clinical appearance, difficulties of differential diagnosis and poor prognosis.
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Polgár et al. (2000) conducted a case report in Breast cancer (n=5,100). Radiotherapy vs. Healthy population was evaluated on Secondary angiosarcoma of the chest wall and breast (OR 2.9). Radiotherapy for primary breast cancer was associated with a secondary angiosarcoma incidence of 0.46 per 1,000, yielding an estimated odds ratio of 2.9 compared to the healthy population.
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