Published in:
26-12-2023 | Radiotherapy | Original Article
Radiation-induced angiosarcoma of the breast: retrospective analysis at a regional treatment centre
Published in: Breast Cancer | Issue 2/2024
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Background
Radiation-induced angiosarcoma (RIA) is an uncommon but morbid complication after radiotherapy for breast cancer.
Methods
Retrospective analysis of breast RIA patients at Cambridge University Hospital (CUH), a regional treatment centre in the East of England.
Results
22 patients were identified between 2010 and 2022. Median age of diagnosis was 65 years (range 41–78). Median time from breast radiotherapy to RIA diagnosis was 6.5 years (range 2.4–16.0)—this interval has decreased over the last 24 years (r2 = 0.6601). 9% had metastasis at presentation. All patients underwent surgery (55% at CUH, 45% at local hospitals). 27% received peri-operative pegylated liposomal doxorubicin in the first-line setting. 62% relapsed following their primary curative-intent treatments after a median of 28 months. Metastases occurred in 36%, the commonest sites being lung (100%) and lymph node (50%). 2-year and 5-year overall survival (OS) rates for all patients were 73% and 60%, respectively. No correlation between progression-free survival (PFS) and OS was found with tumour size, margin, peri-operative chemotherapy, and whether surgery was performed at CUH. Patients with multifocal disease on their breasts had shorter PFS following surgery compared to single-lesion disease (median 10 vs 65 months; HR = 4.359 [95% CI 1.342–14.16]; P = 0.0143). Patients aged > 72 years had a median OS of 45 months vs 102 months for those ≤ 72 years (HR = 7.129 [95% CI 1.646–30.88]; P = 0.0086).
Conclusion
RIA has high rates of recurrence and mortality and appears to be occurring sooner after breast radiotherapy. Further studies on its pathogenesis and effective treatment are warranted.