Key result
Prior breast cancer linked to ~74-fold higher breast angiosarcoma risk, pointing to radiotherapy.
Why the study?
Sarcomas of the breast are rare and the etiologic and prognostic factors, including the role of prior breast cancer history, are not well understood.
Is a history of breast cancer associated with an increased risk of developing breast sarcoma?
Case-Control
Yes
Is a history of breast cancer associated with an increased risk of developing breast sarcoma?
A history of breast cancer ≥ 5 years prior is strongly associated with the development of angiosarcoma of the breast, suggesting radiotherapy as a contributing factor.
May prompt long-term angiosarcoma vigilance in breast cancer survivors; extends observational links but leaves open prospective validation and screening utility.
PURPOSE: Sarcomas of the breast account for about 1% of all breast malignancies. The aim of this national survey was to explore etiologic and prognostic factors. METHODS: Utilizing national Swedish registers, all patients registered with mesenchymal tumors in the breast during the period 1993-2013 (n = 344) were identified and compared to up to ten age and gender matched controls. Cancer history was retrieved for cases and controls. Conditional Poisson regression models were used for calculation of odds ratios. RESULTS: Previous breast cancer was overrepresented among patients with angiosarcoma. The highest risk occurred ≥ 5 years after treatment for breast cancer (OR 73.9, 95% confidence interval, CI, 25.4-215; P < 0.001). An increase in incidence of angiosarcoma was observed during the study period (1.10, 95% CI 1.05-1.16; P < 0.001). The overall incidence of breast sarcoma increased from 1.52 to 2.04 cases per million per year. Angiosarcoma of the breast was associated with a significant excess mortality compared to age-matched controls (HR 4.65, 95% CI 3.01-7.19; P < 0.001). CONCLUSIONS: Angiosarcoma increased in incidence and displayed a more severe clinical course, with significantly shorter survival. The strong association between a history of breast cancer 5 years or more prior to the diagnosis of angiosarcoma points to radiotherapy as a contributing factor.
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Karlsson et al. (2020) conducted a case-control in Breast sarcoma. History of breast cancer vs. No history of breast cancer was evaluated on Development of angiosarcoma ≥ 5 years after breast cancer treatment (OR 73.9, 95% CI 25.4-215, p=<0.001). A history of breast cancer 5 or more years prior was strongly associated with the development of breast angiosarcoma (OR 73.9), pointing to radiotherapy as a contributing factor.
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