The spectrum of vascular lesions in the mammary skin, including angiosarcoma, after breast conservation treatment for breast cancer
Identifieur interne : 000392 ( Istex/Corpus ); précédent : 000391; suivant : 000393The spectrum of vascular lesions in the mammary skin, including angiosarcoma, after breast conservation treatment for breast cancer
Auteurs : Stephen F. Sener ; Steven Milos ; Joseph L. Feldman ; Carole H. Martz ; David J. Winchester ; Mark Dieterich ; Gershon Y. Locker ; Janardan D. Khandekar ; Bruce Brockstein ; Max Haid ; Arthur MichelSource :
- Journal of the American College of Surgeons [ 1072-7515 ] ; 2001.
Abstract
BACKGROUND: With the general acceptance of lumpectomy, axillary staging, and radiotherapy as local treatment for infiltrating breast cancer, an appreciation is evolving for the spectrum of vascular lesions that occur in the mammary skin after this treatment. Most of these lesions develop within the prior radiation field after breast conservation treatment. STUDY DESIGN: A retrospective chart and slide review was conducted, consisting of five patients with cutaneous vascular lesions after breast conservation treatment for infiltrating breast cancer. RESULTS: The latent time interval from definitive treatment of breast cancer to the clinical recognition of vascular lesions ranged from 5 to 11 years. Two patients did not have either arm or breast edema, two patients had breast edema, and the fifth patient had arm edema. Lesions arising in the irradiated mammary skin included extensive lymphangiectasia (one), atypical vascular lesions (two), and cutaneous angiosarcoma (four). CONCLUSIONS: Atypical vascular lesions at the skin margins of mastectomy may be predictive of recurrence after resection of angiosarcoma. Excision of skin from the entire radiation field may be necessary to secure local control of the chest wall in patients with cutaneous angiosarcoma after therapeutic breast radiotherapy.
Url:
DOI: 10.1016/S1072-7515(01)00863-8
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Feldman</name><affiliation><mods:affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Martz, Carole H" sort="Martz, Carole H" uniqKey="Martz C" first="Carole H" last="Martz">Carole H. Martz</name><affiliation><mods:affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Winchester, David J" sort="Winchester, David J" uniqKey="Winchester D" first="David J" last="Winchester">David J. Winchester</name><affiliation><mods:affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Dieterich, Mark" sort="Dieterich, Mark" uniqKey="Dieterich M" first="Mark" last="Dieterich">Mark Dieterich</name><affiliation><mods:affiliation>Department of Pathology, Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Locker, Gershon Y" sort="Locker, Gershon Y" uniqKey="Locker G" first="Gershon Y" last="Locker">Gershon Y. Locker</name><affiliation><mods:affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Khandekar, Janardan D" sort="Khandekar, Janardan D" uniqKey="Khandekar J" first="Janardan D" last="Khandekar">Janardan D. 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Sener</name><affiliation><mods:affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Milos, Steven" sort="Milos, Steven" uniqKey="Milos S" first="Steven" last="Milos">Steven Milos</name><affiliation><mods:affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Feldman, Joseph L" sort="Feldman, Joseph L" uniqKey="Feldman J" first="Joseph L" last="Feldman">Joseph L. Feldman</name><affiliation><mods:affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Martz, Carole H" sort="Martz, Carole H" uniqKey="Martz C" first="Carole H" last="Martz">Carole H. Martz</name><affiliation><mods:affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Winchester, David J" sort="Winchester, David J" uniqKey="Winchester D" first="David J" last="Winchester">David J. Winchester</name><affiliation><mods:affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Dieterich, Mark" sort="Dieterich, Mark" uniqKey="Dieterich M" first="Mark" last="Dieterich">Mark Dieterich</name><affiliation><mods:affiliation>Department of Pathology, Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Locker, Gershon Y" sort="Locker, Gershon Y" uniqKey="Locker G" first="Gershon Y" last="Locker">Gershon Y. Locker</name><affiliation><mods:affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Khandekar, Janardan D" sort="Khandekar, Janardan D" uniqKey="Khandekar J" first="Janardan D" last="Khandekar">Janardan D. Khandekar</name><affiliation><mods:affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Brockstein, Bruce" sort="Brockstein, Bruce" uniqKey="Brockstein B" first="Bruce" last="Brockstein">Bruce Brockstein</name><affiliation><mods:affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Haid, Max" sort="Haid, Max" uniqKey="Haid M" first="Max" last="Haid">Max Haid</name><affiliation><mods:affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author><author><name sortKey="Michel, Arthur" sort="Michel, Arthur" uniqKey="Michel A" first="Arthur" last="Michel">Arthur Michel</name><affiliation><mods:affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of the American College of Surgeons</title><title level="j" type="abbrev">ACS</title><idno type="ISSN">1072-7515</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2001">2001</date><biblScope unit="volume">193</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="22">22</biblScope><biblScope unit="page" to="28">28</biblScope></imprint><idno type="ISSN">1072-7515</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1072-7515</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND: With the general acceptance of lumpectomy, axillary staging, and radiotherapy as local treatment for infiltrating breast cancer, an appreciation is evolving for the spectrum of vascular lesions that occur in the mammary skin after this treatment. Most of these lesions develop within the prior radiation field after breast conservation treatment. STUDY DESIGN: A retrospective chart and slide review was conducted, consisting of five patients with cutaneous vascular lesions after breast conservation treatment for infiltrating breast cancer. RESULTS: The latent time interval from definitive treatment of breast cancer to the clinical recognition of vascular lesions ranged from 5 to 11 years. Two patients did not have either arm or breast edema, two patients had breast edema, and the fifth patient had arm edema. Lesions arising in the irradiated mammary skin included extensive lymphangiectasia (one), atypical vascular lesions (two), and cutaneous angiosarcoma (four). CONCLUSIONS: Atypical vascular lesions at the skin margins of mastectomy may be predictive of recurrence after resection of angiosarcoma. Excision of skin from the entire radiation field may be necessary to secure local control of the chest wall in patients with cutaneous angiosarcoma after therapeutic breast radiotherapy.</div></front></TEI><istex><corpusName>elsevier</corpusName><keywords><teeft><json:string>angiosarcoma</json:string><json:string>radiotherapy</json:string><json:string>cutaneous</json:string><json:string>mastectomy</json:string><json:string>sarcoma</json:string><json:string>breast cancer</json:string><json:string>lumpectomy</json:string><json:string>axillary</json:string><json:string>mammary</json:string><json:string>cutaneous angiosarcoma</json:string><json:string>dermis</json:string><json:string>mammary skin</json:string><json:string>chest wall</json:string><json:string>sener</json:string><json:string>lymphangiectasia</json:string><json:string>surg</json:string><json:string>node</json:string><json:string>lesion</json:string><json:string>breast edema</json:string><json:string>vascular lesions</json:string><json:string>breast conservation treatment</json:string><json:string>skin margins</json:string><json:string>atypical</json:string><json:string>carcinoma</json:string><json:string>time interval</json:string><json:string>ductal carcinoma</json:string><json:string>right breast</json:string><json:string>extensive lymphangiectasia</json:string><json:string>breast</json:string><json:string>radiation therapy</json:string><json:string>recurrent breast cancer</json:string><json:string>axillary dissection</json:string><json:string>endothelial cells</json:string><json:string>hyperchromatic nuclei</json:string><json:string>edema</json:string><json:string>radiation field</json:string><json:string>recurrent angiosarcoma</json:string><json:string>breast parenchyma</json:string><json:string>superior vena cava syndrome</json:string><json:string>vascular tumors</json:string><json:string>breast carcinoma</json:string><json:string>primary breast cancer treatment</json:string><json:string>radiation dermatitis</json:string><json:string>case report</json:string><json:string>incisional biopsy</json:string><json:string>biopsy</json:string></teeft></keywords><author><json:item><name>Stephen F Sener MD</name><affiliations><json:string>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item><json:item><name>Steven Milos MD</name><affiliations><json:string>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item><json:item><name>Joseph L Feldman MD</name><affiliations><json:string>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item><json:item><name>Carole H Martz RN, MSN</name><affiliations><json:string>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item><json:item><name>David J Winchester MD</name><affiliations><json:string>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item><json:item><name>Mark Dieterich MD</name><affiliations><json:string>Department of Pathology, Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item><json:item><name>Gershon Y Locker MD</name><affiliations><json:string>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item><json:item><name>Janardan D Khandekar MD</name><affiliations><json:string>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item><json:item><name>Bruce Brockstein MD</name><affiliations><json:string>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item><json:item><name>Max Haid MD</name><affiliations><json:string>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item><json:item><name>Arthur Michel MD</name><affiliations><json:string>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</json:string></affiliations></json:item></author><language><json:string>eng</json:string></language><originalGenre><json:string>Full-length article</json:string></originalGenre><abstract>BACKGROUND: With the general acceptance of lumpectomy, axillary staging, and radiotherapy as local treatment for infiltrating breast cancer, an appreciation is evolving for the spectrum of vascular lesions that occur in the mammary skin after this treatment. Most of these lesions develop within the prior radiation field after breast conservation treatment. STUDY DESIGN: A retrospective chart and slide review was conducted, consisting of five patients with cutaneous vascular lesions after breast conservation treatment for infiltrating breast cancer. RESULTS: The latent time interval from definitive treatment of breast cancer to the clinical recognition of vascular lesions ranged from 5 to 11 years. Two patients did not have either arm or breast edema, two patients had breast edema, and the fifth patient had arm edema. Lesions arising in the irradiated mammary skin included extensive lymphangiectasia (one), atypical vascular lesions (two), and cutaneous angiosarcoma (four). CONCLUSIONS: Atypical vascular lesions at the skin margins of mastectomy may be predictive of recurrence after resection of angiosarcoma. Excision of skin from the entire radiation field may be necessary to secure local control of the chest wall in patients with cutaneous angiosarcoma after therapeutic breast radiotherapy.</abstract><qualityIndicators><score>5.553</score><pdfVersion>1.2</pdfVersion><pdfPageSize>576 x 776 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1311</abstractCharCount><pdfWordCount>3285</pdfWordCount><pdfCharCount>21463</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>189</abstractWordCount></qualityIndicators><title>The spectrum of vascular lesions in the mammary skin, including angiosarcoma, after breast conservation treatment for breast cancer</title><pii><json:string>S1072-7515(01)00863-8</json:string></pii><genre><json:string>research-article</json:string></genre><host><title>Journal of the American College of Surgeons</title><language><json:string>unknown</json:string></language><publicationDate>2001</publicationDate><issn><json:string>1072-7515</json:string></issn><pii><json:string>S1072-7515(00)X0049-X</json:string></pii><volume>193</volume><issue>1</issue><pages><first>22</first><last>28</last></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>surgery</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>surgery</json:string></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string></inist></categories><publicationDate>2001</publicationDate><copyrightDate>2001</copyrightDate><doi><json:string>10.1016/S1072-7515(01)00863-8</json:string></doi><id>08B75FA3D866852AA00362D6637AD3DBABE70FD6</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/08B75FA3D866852AA00362D6637AD3DBABE70FD6/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/08B75FA3D866852AA00362D6637AD3DBABE70FD6/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/08B75FA3D866852AA00362D6637AD3DBABE70FD6/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">The spectrum of vascular lesions in the mammary skin, including angiosarcoma, after breast conservation treatment for breast cancer</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>©2001 American College of Surgeons</p></availability><date>2001</date></publicationStmt><notesStmt><note>No competing interests declared.</note><note type="content">Figure 1: Angiosarcoma of the mammary skin of patient no. 3. Section demonstrates a high-grade sarcoma with irregular anastomosing vascular channels, lined by highly atypical endothelial cells infiltrating the dermis. (Hematoxylin and eosin; ×400).</note><note type="content">Figure 2: Atypical vascular lesion of the mammary skin of patient no. 3. Section demonstrates branching ectatic blood vessels in the dermis, lined by endothelial cells with enlarged hyperchromatic nuclei, occasionally showing a “hobnail” appearance. (Hematoxylin and eosin, ×400).</note><note type="content">Table 1: Clinical and Pathologic Characteristics of Lesions that Developed after Lumpectomy, Axillary Staging, and Radiotherapy for Infiltrating Breast Cancer</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">The spectrum of vascular lesions in the mammary skin, including angiosarcoma, after breast conservation treatment for breast cancer</title><author xml:id="author-0000"><persName><forename type="first">Stephen F</forename><surname>Sener</surname></persName><roleName type="degree">MD</roleName><note type="biography">FACS</note><affiliation>FACS</affiliation><note type="correspondence"><p>Correspondence address: Stephen F Sener, MD, Evanston Northwestern Healthcare, 2650 Ridge, Burch #106, Evanston, IL 60201</p></note><affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Steven</forename><surname>Milos</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Joseph L</forename><surname>Feldman</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Carole H</forename><surname>Martz</surname></persName><roleName type="degree">RN, MSN</roleName><affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><author xml:id="author-0004"><persName><forename type="first">David J</forename><surname>Winchester</surname></persName><roleName type="degree">MD</roleName><note type="biography">FACS</note><affiliation>FACS</affiliation><affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Mark</forename><surname>Dieterich</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Pathology, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><author xml:id="author-0006"><persName><forename type="first">Gershon Y</forename><surname>Locker</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><author xml:id="author-0007"><persName><forename type="first">Janardan D</forename><surname>Khandekar</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><author xml:id="author-0008"><persName><forename type="first">Bruce</forename><surname>Brockstein</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><author xml:id="author-0009"><persName><forename type="first">Max</forename><surname>Haid</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><author xml:id="author-0010"><persName><forename type="first">Arthur</forename><surname>Michel</surname></persName><roleName type="degree">MD</roleName><note type="biography">FACS</note><note type="biography">(deceased)</note><affiliation>FACS</affiliation><affiliation>(deceased)</affiliation><affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation></author><idno type="istex">08B75FA3D866852AA00362D6637AD3DBABE70FD6</idno><idno type="DOI">10.1016/S1072-7515(01)00863-8</idno><idno type="PII">S1072-7515(01)00863-8</idno></analytic><monogr><title level="j">Journal of the American College of Surgeons</title><title level="j" type="abbrev">ACS</title><idno type="pISSN">1072-7515</idno><idno type="PII">S1072-7515(00)X0049-X</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2001"></date><biblScope unit="volume">193</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="22">22</biblScope><biblScope unit="page" to="28">28</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2001</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>BACKGROUND: With the general acceptance of lumpectomy, axillary staging, and radiotherapy as local treatment for infiltrating breast cancer, an appreciation is evolving for the spectrum of vascular lesions that occur in the mammary skin after this treatment. Most of these lesions develop within the prior radiation field after breast conservation treatment. STUDY DESIGN: A retrospective chart and slide review was conducted, consisting of five patients with cutaneous vascular lesions after breast conservation treatment for infiltrating breast cancer. RESULTS: The latent time interval from definitive treatment of breast cancer to the clinical recognition of vascular lesions ranged from 5 to 11 years. Two patients did not have either arm or breast edema, two patients had breast edema, and the fifth patient had arm edema. Lesions arising in the irradiated mammary skin included extensive lymphangiectasia (one), atypical vascular lesions (two), and cutaneous angiosarcoma (four). CONCLUSIONS: Atypical vascular lesions at the skin margins of mastectomy may be predictive of recurrence after resection of angiosarcoma. Excision of skin from the entire radiation field may be necessary to secure local control of the chest wall in patients with cutaneous angiosarcoma after therapeutic breast radiotherapy.</p></abstract></profileDesc><revisionDesc><change when="2001-03-01">Modified</change><change when="2001">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/08B75FA3D866852AA00362D6637AD3DBABE70FD6/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: ce:floats; body; tail"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"><istex:entity SYSTEM="gr1" NDATA="IMAGE" name="GR1"></istex:entity><istex:entity SYSTEM="gr2" NDATA="IMAGE" name="GR2"></istex:entity></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>ACS</jid><aid>1484</aid><ce:pii>S1072-7515(01)00863-8</ce:pii><ce:doi>10.1016/S1072-7515(01)00863-8</ce:doi><ce:copyright type="society" year="2001">American College of Surgeons</ce:copyright></item-info><head><ce:title>The spectrum of vascular lesions in the mammary skin, including angiosarcoma, after breast conservation treatment for breast cancer<ce:cross-ref refid="FN1"><ce:sup>1</ce:sup></ce:cross-ref> <ce:footnote id="FN1"><ce:label>1</ce:label><ce:note-para>No competing interests declared.</ce:note-para></ce:footnote></ce:title><ce:author-group><ce:author><ce:given-name>Stephen F</ce:given-name><ce:surname>Sener</ce:surname><ce:degrees>MD</ce:degrees><ce:roles>FACS</ce:roles><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref><ce:cross-ref refid="CORR1">*</ce:cross-ref></ce:author><ce:author><ce:given-name>Steven</ce:given-name><ce:surname>Milos</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Joseph L</ce:given-name><ce:surname>Feldman</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Carole H</ce:given-name><ce:surname>Martz</ce:surname><ce:degrees>RN, MSN</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>David J</ce:given-name><ce:surname>Winchester</ce:surname><ce:degrees>MD</ce:degrees><ce:roles>FACS</ce:roles><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Mark</ce:given-name><ce:surname>Dieterich</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF3"><ce:sup>c</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Gershon Y</ce:given-name><ce:surname>Locker</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Janardan D</ce:given-name><ce:surname>Khandekar</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Bruce</ce:given-name><ce:surname>Brockstein</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Max</ce:given-name><ce:surname>Haid</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Arthur</ce:given-name><ce:surname>Michel</ce:surname><ce:degrees>MD</ce:degrees><ce:roles>FACS</ce:roles><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF4"><ce:sup>d</ce:sup></ce:cross-ref><ce:cross-ref refid="FN2"><ce:sup>2</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>a</ce:label><ce:textfn>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>b</ce:label><ce:textfn>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</ce:textfn></ce:affiliation><ce:affiliation id="AFF3"><ce:label>c</ce:label><ce:textfn>Department of Pathology, Evanston Northwestern Healthcare, Evanston, IL, USA</ce:textfn></ce:affiliation><ce:affiliation id="AFF4"><ce:label>d</ce:label><ce:textfn>Northwestern University Medical School, Chicago, IL, USA</ce:textfn></ce:affiliation><ce:correspondence id="CORR1"><ce:label>*</ce:label><ce:text>Correspondence address: Stephen F Sener, MD, Evanston Northwestern Healthcare, 2650 Ridge, Burch #106, Evanston, IL 60201</ce:text></ce:correspondence><ce:footnote id="FN2"><ce:label>2</ce:label><ce:note-para>(deceased)</ce:note-para></ce:footnote></ce:author-group><ce:date-received day="12" month="1" year="2001"></ce:date-received><ce:date-revised day="1" month="3" year="2001"></ce:date-revised><ce:date-accepted day="2" month="3" year="2001"></ce:date-accepted><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>BACKGROUND:</ce:simple-para><ce:simple-para>With the general acceptance of lumpectomy, axillary staging, and radiotherapy as local treatment for infiltrating breast cancer, an appreciation is evolving for the spectrum of vascular lesions that occur in the mammary skin after this treatment. Most of these lesions develop within the prior radiation field after breast conservation treatment.</ce:simple-para><ce:simple-para>STUDY DESIGN:</ce:simple-para><ce:simple-para>A retrospective chart and slide review was conducted, consisting of five patients with cutaneous vascular lesions after breast conservation treatment for infiltrating breast cancer.</ce:simple-para><ce:simple-para>RESULTS:</ce:simple-para><ce:simple-para>The latent time interval from definitive treatment of breast cancer to the clinical recognition of vascular lesions ranged from 5 to 11 years. Two patients did not have either arm or breast edema, two patients had breast edema, and the fifth patient had arm edema. Lesions arising in the irradiated mammary skin included extensive lymphangiectasia (one), atypical vascular lesions (two), and cutaneous angiosarcoma (four).</ce:simple-para><ce:simple-para>CONCLUSIONS:</ce:simple-para><ce:simple-para>Atypical vascular lesions at the skin margins of mastectomy may be predictive of recurrence after resection of angiosarcoma. Excision of skin from the entire radiation field may be necessary to secure local control of the chest wall in patients with cutaneous angiosarcoma after therapeutic breast radiotherapy.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>The spectrum of vascular lesions in the mammary skin, including angiosarcoma, after breast conservation treatment for breast cancer</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>The spectrum of vascular lesions in the mammary skin, including angiosarcoma, after breast conservation treatment for breast cancer</title></titleInfo><name type="personal"><namePart type="given">Stephen F</namePart><namePart type="family">Sener</namePart><namePart type="termsOfAddress">MD</namePart><description>FACS</description><affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><description>Correspondence address: Stephen F Sener, MD, Evanston Northwestern Healthcare, 2650 Ridge, Burch #106, Evanston, IL 60201</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Steven</namePart><namePart type="family">Milos</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joseph L</namePart><namePart type="family">Feldman</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Carole H</namePart><namePart type="family">Martz</namePart><namePart type="termsOfAddress">RN, MSN</namePart><affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">David J</namePart><namePart type="family">Winchester</namePart><namePart type="termsOfAddress">MD</namePart><description>FACS</description><affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mark</namePart><namePart type="family">Dieterich</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Pathology, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gershon Y</namePart><namePart type="family">Locker</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Janardan D</namePart><namePart type="family">Khandekar</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bruce</namePart><namePart type="family">Brockstein</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Max</namePart><namePart type="family">Haid</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medicine, and Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Arthur</namePart><namePart type="family">Michel</namePart><namePart type="termsOfAddress">MD</namePart><description>FACS</description><affiliation>Department of Surgery, Evanston Northwestern Healthcare, Evanston, IL, USA</affiliation><description>(deceased)</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">2001</dateIssued><dateModified encoding="w3cdtf">2001-03-01</dateModified><copyrightDate encoding="w3cdtf">2001</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">BACKGROUND: With the general acceptance of lumpectomy, axillary staging, and radiotherapy as local treatment for infiltrating breast cancer, an appreciation is evolving for the spectrum of vascular lesions that occur in the mammary skin after this treatment. Most of these lesions develop within the prior radiation field after breast conservation treatment. STUDY DESIGN: A retrospective chart and slide review was conducted, consisting of five patients with cutaneous vascular lesions after breast conservation treatment for infiltrating breast cancer. RESULTS: The latent time interval from definitive treatment of breast cancer to the clinical recognition of vascular lesions ranged from 5 to 11 years. Two patients did not have either arm or breast edema, two patients had breast edema, and the fifth patient had arm edema. Lesions arising in the irradiated mammary skin included extensive lymphangiectasia (one), atypical vascular lesions (two), and cutaneous angiosarcoma (four). CONCLUSIONS: Atypical vascular lesions at the skin margins of mastectomy may be predictive of recurrence after resection of angiosarcoma. Excision of skin from the entire radiation field may be necessary to secure local control of the chest wall in patients with cutaneous angiosarcoma after therapeutic breast radiotherapy.</abstract><note type="footnote">No competing interests declared.</note><note type="content">Figure 1: Angiosarcoma of the mammary skin of patient no. 3. Section demonstrates a high-grade sarcoma with irregular anastomosing vascular channels, lined by highly atypical endothelial cells infiltrating the dermis. (Hematoxylin and eosin; ×400).</note><note type="content">Figure 2: Atypical vascular lesion of the mammary skin of patient no. 3. Section demonstrates branching ectatic blood vessels in the dermis, lined by endothelial cells with enlarged hyperchromatic nuclei, occasionally showing a “hobnail” appearance. (Hematoxylin and eosin, ×400).</note><note type="content">Table 1: Clinical and Pathologic Characteristics of Lesions that Developed after Lumpectomy, Axillary Staging, and Radiotherapy for Infiltrating Breast Cancer</note><relatedItem type="host"><titleInfo><title>Journal of the American College of Surgeons</title></titleInfo><titleInfo type="abbreviated"><title>ACS</title></titleInfo><genre type="journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">200107</dateIssued></originInfo><identifier type="ISSN">1072-7515</identifier><identifier type="PII">S1072-7515(00)X0049-X</identifier><part><date>200107</date><detail type="volume"><number>193</number><caption>vol.</caption></detail><detail type="issue"><number>1</number><caption>no.</caption></detail><extent unit="issue pages"><start>1</start><end>118</end></extent><extent unit="pages"><start>22</start><end>28</end></extent></part></relatedItem><identifier type="istex">08B75FA3D866852AA00362D6637AD3DBABE70FD6</identifier><identifier type="DOI">10.1016/S1072-7515(01)00863-8</identifier><identifier type="PII">S1072-7515(01)00863-8</identifier><accessCondition type="use and reproduction" contentType="copyright">©2001 American College of Surgeons</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>American College of Surgeons, ©2001</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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