Risk of Angiosarcoma Following Breast Conservation: A Clinical Alert
Identifieur interne : 001975 ( Istex/Corpus ); précédent : 001974; suivant : 001976Risk of Angiosarcoma Following Breast Conservation: A Clinical Alert
Auteurs : John G. West ; Azhar Qureshi ; Justin E. West ; Monique Chacon ; M. Linda Sutherland ; Bijan Haghighi ; Judith HarrisonSource :
- The Breast Journal [ 1075-122X ] ; 2005-03.
Abstract
Abstract: Approximately 100 cases of angiosarcoma following breast‐conserving therapy have been reported. The prevalence of angiosarcoma following breast conservation has not been accurately established and optimal treatment has not been defined. The goal of this article is to clarify both issues. The Fisher's exact test was used to compare the prevalence of postirradiation angiosarcoma seen in our private practice to the prevalence reported from the two largest national database studies. A literature review was performed to determine optimal treatment guidelines. The results of the comparison indicated that the prevalence of postirradiation angiosarcoma seen in our practice was significantly higher than that reported in the two national database studies at p‐values of 0.0124 and 0.0080. Also, results from the literature review suggest that early detection and aggressive treatment lead to improved outcomes. The data are insufficient to draw firm conclusions, but suggest that the current literature underestimates the prevalence of angiosarcoma following breast‐conserving therapy. Since elderly women derive less benefit from radiation and may be more prone to develop postirradiation angiosarcoma, confirmation of our findings could lead to a reappraisal of the management of elderly patients with early stage breast cancer.
Url:
DOI: 10.1111/j.1075-122X.2005.21548.x
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ISTEX:37B66C90E66D89BE9629C41D670B4168CC7381B0Le document en format XML
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West</name><affiliation><mods:affiliation>Breast Care Center, Cordelia Knott Center for Wellness, Orange, California;</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jwest@breastcare.com</mods:affiliation></affiliation></author><author><name sortKey="Qureshi, Azhar" sort="Qureshi, Azhar" uniqKey="Qureshi A" first="Azhar" last="Qureshi">Azhar Qureshi</name><affiliation><mods:affiliation>Clinical Quality, St. Joseph Health Systems, Orange, California;</mods:affiliation></affiliation></author><author><name sortKey="West, Justin E" sort="West, Justin E" uniqKey="West J" first="Justin E." last="West">Justin E. West</name><affiliation><mods:affiliation>Department of Plastic Surgery, Georgetown University, Washington, DC;</mods:affiliation></affiliation></author><author><name sortKey="Chacon, Monique" sort="Chacon, Monique" uniqKey="Chacon M" first="Monique" last="Chacon">Monique Chacon</name><affiliation><mods:affiliation>University of California, Irvine, California;</mods:affiliation></affiliation></author><author><name sortKey="Sutherland, M Linda" sort="Sutherland, M Linda" uniqKey="Sutherland M" first="M. Linda" last="Sutherland">M. Linda Sutherland</name><affiliation><mods:affiliation>Breast Imaging, St. Joseph Comprehensive Breast Center, Orange, California</mods:affiliation></affiliation></author><author><name sortKey="Haghighi, Bijan" sort="Haghighi, Bijan" uniqKey="Haghighi B" first="Bijan" last="Haghighi">Bijan Haghighi</name><affiliation><mods:affiliation>Department of Pathology</mods:affiliation></affiliation></author><author><name sortKey="Harrison, Judith" sort="Harrison, Judith" uniqKey="Harrison J" first="Judith" last="Harrison">Judith Harrison</name><affiliation><mods:affiliation>Radiation Oncology, St. Joseph Hospital, Orange, California</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">The Breast Journal</title><title level="j" type="alt">BREAST JOURNAL</title><idno type="ISSN">1075-122X</idno><idno type="eISSN">1524-4741</idno><imprint><biblScope unit="vol">11</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="115">115</biblScope><biblScope unit="page" to="123">123</biblScope><biblScope unit="page-count">9</biblScope><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2005-03">2005-03</date></imprint><idno type="ISSN">1075-122X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1075-122X</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Abstract: Approximately 100 cases of angiosarcoma following breast‐conserving therapy have been reported. The prevalence of angiosarcoma following breast conservation has not been accurately established and optimal treatment has not been defined. The goal of this article is to clarify both issues. The Fisher's exact test was used to compare the prevalence of postirradiation angiosarcoma seen in our private practice to the prevalence reported from the two largest national database studies. A literature review was performed to determine optimal treatment guidelines. The results of the comparison indicated that the prevalence of postirradiation angiosarcoma seen in our practice was significantly higher than that reported in the two national database studies at p‐values of 0.0124 and 0.0080. Also, results from the literature review suggest that early detection and aggressive treatment lead to improved outcomes. The data are insufficient to draw firm conclusions, but suggest that the current literature underestimates the prevalence of angiosarcoma following breast‐conserving therapy. Since elderly women derive less benefit from radiation and may be more prone to develop postirradiation angiosarcoma, confirmation of our findings could lead to a reappraisal of the management of elderly patients with early stage breast cancer. </div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>angiosarcoma</json:string><json:string>postirradiation</json:string><json:string>oncol</json:string><json:string>postirradiation angiosarcoma</json:string><json:string>surg</json:string><json:string>mastectomy</json:string><json:string>radiotherapy</json:string><json:string>lymphedema</json:string><json:string>breast conservation</json:string><json:string>sarcoma</json:string><json:string>breast cancer</json:string><json:string>radiation therapy</json:string><json:string>latency</json:string><json:string>lumpectomy</json:string><json:string>radiat</json:string><json:string>surg oncol</json:string><json:string>biol</json:string><json:string>nodule</json:string><json:string>clin</json:string><json:string>radiat oncol biol phys</json:string><json:string>punch biopsy</json:string><json:string>early detection</json:string><json:string>latency period</json:string><json:string>local recurrence</json:string><json:string>breast</json:string><json:string>recurrence</json:string><json:string>biopsy</json:string><json:string>skin nodule</json:string><json:string>cutaneous angiosarcoma</json:string><json:string>case report</json:string><json:string>french series</json:string><json:string>dutch series</json:string><json:string>skin discoloration</json:string><json:string>breast cancer treatment</json:string><json:string>chest wall</json:string><json:string>primary breast cancer</json:string><json:string>postirradiation angiosarcomas</json:string><json:string>breast carcinoma</json:string><json:string>mastectomy specimen</json:string><json:string>carcinoma</json:string><json:string>primary angiosarcoma</json:string><json:string>postirradiated breast</json:string><json:string>recent review</json:string><json:string>risk factor</json:string><json:string>time period</json:string><json:string>open biopsy</json:string><json:string>conservative treatment</json:string><json:string>inclusion criteria</json:string><json:string>breast pain</json:string><json:string>clin oncol</json:string><json:string>skin changes</json:string><json:string>axillary lymph node dissection</json:string><json:string>prevalence</json:string><json:string>second recurrence</json:string><json:string>breast irradiation</json:string><json:string>chronic lymphedema</json:string><json:string>malignant transformation</json:string><json:string>skin hemorrhage</json:string><json:string>tissue sarcomas</json:string><json:string>literature review</json:string><json:string>breast edema</json:string><json:string>soft tissue sarcomas</json:string><json:string>early breast cancer</json:string><json:string>breast angiosarcomas</json:string><json:string>vascular lesions</json:string><json:string>total mastectomy</json:string><json:string>extensive angiosarcoma</json:string><json:string>study group</json:string><json:string>elderly women</json:string><json:string>skin punch biopsy</json:string><json:string>early stage breast cancer</json:string><json:string>statistical methods</json:string><json:string>period prevalence proportion</json:string><json:string>breast lump</json:string><json:string>address correspondence</json:string><json:string>exact test</json:string><json:string>statistical analysis</json:string><json:string>private practice</json:string><json:string>pathologic correlation</json:string><json:string>invasive cancer</json:string><json:string>relative risk</json:string><json:string>bilateral angiosarcoma</json:string><json:string>plast surg</json:string><json:string>soft tissue sarcoma</json:string><json:string>clin pathol</json:string><json:string>prognostic factors</json:string><json:string>core biopsy</json:string></teeft></keywords><author><json:item><name>John G. West MD</name><affiliations><json:string>Breast Care Center, Cordelia Knott Center for Wellness, Orange, California;</json:string><json:string>E-mail: jwest@breastcare.com</json:string></affiliations></json:item><json:item><name>Azhar Qureshi MD, PhD</name><affiliations><json:string>Clinical Quality, St. Joseph Health Systems, Orange, California;</json:string></affiliations></json:item><json:item><name>Justin E. West MD</name><affiliations><json:string>Department of Plastic Surgery, Georgetown University, Washington, DC;</json:string></affiliations></json:item><json:item><name>Monique Chacon</name><affiliations><json:string>University of California, Irvine, California;</json:string></affiliations></json:item><json:item><name>M. Linda Sutherland MD</name><affiliations><json:string>Breast Imaging, St. Joseph Comprehensive Breast Center, Orange, California</json:string></affiliations></json:item><json:item><name>Bijan Haghighi MD</name><affiliations><json:string>Department of Pathology</json:string></affiliations></json:item><json:item><name>Judith Harrison MD</name><affiliations><json:string>Radiation Oncology, St. Joseph Hospital, Orange, California</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>angiosarcoma</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>breast‐conserving therapy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>breast neoplasm</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>lymphedema</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>radiotherapy adverse effects</value></json:item></subject><articleId><json:string>TBJ21548</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Abstract: Approximately 100 cases of angiosarcoma following breast‐conserving therapy have been reported. The prevalence of angiosarcoma following breast conservation has not been accurately established and optimal treatment has not been defined. The goal of this article is to clarify both issues. The Fisher's exact test was used to compare the prevalence of postirradiation angiosarcoma seen in our private practice to the prevalence reported from the two largest national database studies. A literature review was performed to determine optimal treatment guidelines. The results of the comparison indicated that the prevalence of postirradiation angiosarcoma seen in our practice was significantly higher than that reported in the two national database studies at p‐values of 0.0124 and 0.0080. Also, results from the literature review suggest that early detection and aggressive treatment lead to improved outcomes. The data are insufficient to draw firm conclusions, but suggest that the current literature underestimates the prevalence of angiosarcoma following breast‐conserving therapy. Since elderly women derive less benefit from radiation and may be more prone to develop postirradiation angiosarcoma, confirmation of our findings could lead to a reappraisal of the management of elderly patients with early stage breast cancer.</abstract><qualityIndicators><score>6.929</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595 x 782 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1342</abstractCharCount><pdfWordCount>4649</pdfWordCount><pdfCharCount>30051</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>190</abstractWordCount></qualityIndicators><title>Risk of Angiosarcoma Following Breast Conservation: A Clinical Alert</title><genre><json:string>article</json:string></genre><host><title>The Breast Journal</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1524-4741</json:string></doi><issn><json:string>1075-122X</json:string></issn><eissn><json:string>1524-4741</json:string></eissn><publisherId><json:string>TBJ</json:string></publisherId><volume>11</volume><issue>2</issue><pages><first>115</first><last>123</last><total>9</total></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>oncology</json:string><json:string>obstetrics & gynecology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>oncology & carcinogenesis</json:string></scienceMetrix></categories><publicationDate>2005</publicationDate><copyrightDate>2005</copyrightDate><doi><json:string>10.1111/j.1075-122X.2005.21548.x</json:string></doi><id>37B66C90E66D89BE9629C41D670B4168CC7381B0</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/37B66C90E66D89BE9629C41D670B4168CC7381B0/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/37B66C90E66D89BE9629C41D670B4168CC7381B0/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/37B66C90E66D89BE9629C41D670B4168CC7381B0/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Risk of Angiosarcoma Following Breast Conservation: A Clinical Alert</title></titleStmt><publicationStmt><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2005-03"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Risk of Angiosarcoma Following Breast Conservation: A Clinical Alert</title><title level="a" type="short">Angiosarcoma Following Breast Conservation</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">John G.</forename><surname>West</surname><roleName type="degree">MD</roleName></persName><affiliation>Breast Care Center, Cordelia Knott Center for Wellness, Orange, California;<address><country key="US"></country></address></affiliation><affiliation>Address correspondence and reprint requests to: John G. West, MD, 230 S. 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Linda</forename><surname>Sutherland</surname><roleName type="degree">MD</roleName></persName><affiliation>Breast Imaging, St. Joseph Comprehensive Breast Center, Orange, California<address><country key="US"></country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Bijan</forename><surname>Haghighi</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Pathology</affiliation></author><author xml:id="author-0006"><persName><forename type="first">Judith</forename><surname>Harrison</surname><roleName type="degree">MD</roleName></persName><affiliation>Radiation Oncology, St. Joseph Hospital, Orange, California<address><country key="US"></country></address></affiliation></author><idno type="istex">37B66C90E66D89BE9629C41D670B4168CC7381B0</idno><idno type="DOI">10.1111/j.1075-122X.2005.21548.x</idno><idno type="unit">TBJ21548</idno><idno type="toTypesetVersion">file:TBJ.TBJ21548.pdf</idno></analytic><monogr><title level="j" type="main">The Breast Journal</title><title level="j" type="alt">BREAST JOURNAL</title><idno type="pISSN">1075-122X</idno><idno type="eISSN">1524-4741</idno><idno type="book-DOI">10.1111/(ISSN)1524-4741</idno><idno type="book-part-DOI">10.1111/tbj.2005.11.issue-2</idno><idno type="product">TBJ</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">11</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="115">115</biblScope><biblScope unit="page" to="123">123</biblScope><biblScope unit="page-count">9</biblScope><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2005-03"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><p><hi rend="bold">Abstract: </hi> Approximately 100 cases of angiosarcoma following breast‐conserving therapy have been reported. The prevalence of angiosarcoma following breast conservation has not been accurately established and optimal treatment has not been defined. The goal of this article is to clarify both issues. The Fisher's exact test was used to compare the prevalence of postirradiation angiosarcoma seen in our private practice to the prevalence reported from the two largest national database studies. A literature review was performed to determine optimal treatment guidelines. The results of the comparison indicated that the prevalence of postirradiation angiosarcoma seen in our practice was significantly higher than that reported in the two national database studies at <hi rend="italic">p</hi>‐values of 0.0124 and 0.0080. Also, results from the literature review suggest that early detection and aggressive treatment lead to improved outcomes. The data are insufficient to draw firm conclusions, but suggest that the current literature underestimates the prevalence of angiosarcoma following breast‐conserving therapy. Since elderly women derive less benefit from radiation and may be more prone to develop postirradiation angiosarcoma, confirmation of our findings could lead to a reappraisal of the management of elderly patients with early stage breast cancer. </p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">angiosarcoma</term><term xml:id="k2">breast‐conserving therapy</term><term xml:id="k3">breast neoplasm</term><term xml:id="k4">lymphedema</term><term xml:id="k5">radiotherapy adverse effects</term></keywords><classCode scheme="tocHeading1">ORIGINAL ARTICLES</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/37B66C90E66D89BE9629C41D670B4168CC7381B0/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Science Inc</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1524-4741</doi><issn type="print">1075-122X</issn><issn type="electronic">1524-4741</issn><idGroup><id type="product" value="TBJ"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="BREAST JOURNAL">The Breast Journal</title></titleGroup></publicationMeta><publicationMeta level="part" position="03002"><doi origin="wiley">10.1111/tbj.2005.11.issue-2</doi><numberingGroup><numbering type="journalVolume" number="11">11</numbering><numbering type="journalIssue" number="2">2</numbering></numberingGroup><coverDate startDate="2005-03">March 2005</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="6" status="forIssue"><doi origin="wiley">10.1111/j.1075-122X.2005.21548.x</doi><idGroup><id type="unit" value="TBJ21548"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title></titleGroup><eventGroup><event type="firstOnline" date="2005-02-23"></event><event type="publishedOnlineFinalForm" date="2005-02-23"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-04"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-10"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-04"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="115">115</numbering><numbering type="pageLast" number="123">123</numbering></numberingGroup><correspondenceTo>Address correspondence and reprint requests to: John G. West, MD, 230 S. Main St., Orange, CA 92868, USA, or e‐mail: <email>jwest@breastcare.com</email>.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:TBJ.TBJ21548.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="4"></count><count type="tableTotal" number="2"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="63"></count><count type="wordTotal" number="3203"></count></countGroup><titleGroup><title type="main">Risk of Angiosarcoma Following Breast Conservation: A Clinical Alert</title><title type="shortAuthors"><sc>west et al.</sc></title><title type="short"><i>Angiosarcoma Following Breast Conservation</i></title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>John G.</givenNames><familyName>West</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>Azhar</givenNames><familyName>Qureshi</familyName><degrees>MD, PhD</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a3"><personName><givenNames>Justin E.</givenNames><familyName>West</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a4"><personName><givenNames>Monique</givenNames><familyName>Chacon</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a5"><personName><givenNames>M. Linda</givenNames><familyName>Sutherland</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a6"><personName><givenNames>Bijan</givenNames><familyName>Haghighi</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a7"><personName><givenNames>Judith</givenNames><familyName>Harrison</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="US"><unparsedAffiliation>Breast Care Center, Cordelia Knott Center for Wellness, Orange, California;</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="US"><unparsedAffiliation>Clinical Quality, St. Joseph Health Systems, Orange, California;</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="US"><unparsedAffiliation>Department of Plastic Surgery, Georgetown University, Washington, DC;</unparsedAffiliation></affiliation><affiliation xml:id="a4" countryCode="US"><unparsedAffiliation>University of California, Irvine, California;</unparsedAffiliation></affiliation><affiliation xml:id="a5" countryCode="US"><unparsedAffiliation>Breast Imaging, St. Joseph Comprehensive Breast Center, Orange, California</unparsedAffiliation></affiliation><affiliation xml:id="a6"><unparsedAffiliation>Department of Pathology</unparsedAffiliation></affiliation><affiliation xml:id="a7" countryCode="US"><unparsedAffiliation>Radiation Oncology, St. Joseph Hospital, Orange, California</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">angiosarcoma</keyword><keyword xml:id="k2">breast‐conserving therapy</keyword><keyword xml:id="k3">breast neoplasm</keyword><keyword xml:id="k4">lymphedema</keyword><keyword xml:id="k5">radiotherapy adverse effects</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p><b>Abstract: </b> Approximately 100 cases of angiosarcoma following breast‐conserving therapy have been reported. The prevalence of angiosarcoma following breast conservation has not been accurately established and optimal treatment has not been defined. The goal of this article is to clarify both issues. The Fisher's exact test was used to compare the prevalence of postirradiation angiosarcoma seen in our private practice to the prevalence reported from the two largest national database studies. A literature review was performed to determine optimal treatment guidelines. The results of the comparison indicated that the prevalence of postirradiation angiosarcoma seen in our practice was significantly higher than that reported in the two national database studies at <i>p</i>‐values of 0.0124 and 0.0080. Also, results from the literature review suggest that early detection and aggressive treatment lead to improved outcomes. The data are insufficient to draw firm conclusions, but suggest that the current literature underestimates the prevalence of angiosarcoma following breast‐conserving therapy. Since elderly women derive less benefit from radiation and may be more prone to develop postirradiation angiosarcoma, confirmation of our findings could lead to a reappraisal of the management of elderly patients with early stage breast cancer. </p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Risk of Angiosarcoma Following Breast Conservation: A Clinical Alert</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Angiosarcoma Following Breast Conservation</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Risk of Angiosarcoma Following Breast Conservation: A Clinical Alert</title></titleInfo><name type="personal"><namePart type="given">John G.</namePart><namePart type="family">West</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Breast Care Center, Cordelia Knott Center for Wellness, Orange, California;</affiliation><affiliation>E-mail: jwest@breastcare.com</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Azhar</namePart><namePart type="family">Qureshi</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Clinical Quality, St. Joseph Health Systems, Orange, California;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Justin E.</namePart><namePart type="family">West</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Plastic Surgery, Georgetown University, Washington, DC;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Monique</namePart><namePart type="family">Chacon</namePart><affiliation>University of California, Irvine, California;</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M. Linda</namePart><namePart type="family">Sutherland</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Breast Imaging, St. Joseph Comprehensive Breast Center, Orange, California</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bijan</namePart><namePart type="family">Haghighi</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Pathology</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Judith</namePart><namePart type="family">Harrison</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Radiation Oncology, St. Joseph Hospital, Orange, California</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Science Inc</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2005-03</dateIssued><copyrightDate encoding="w3cdtf">2005</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">4</extent><extent unit="tables">2</extent><extent unit="references">63</extent><extent unit="words">3203</extent></physicalDescription><abstract>Abstract: Approximately 100 cases of angiosarcoma following breast‐conserving therapy have been reported. The prevalence of angiosarcoma following breast conservation has not been accurately established and optimal treatment has not been defined. The goal of this article is to clarify both issues. The Fisher's exact test was used to compare the prevalence of postirradiation angiosarcoma seen in our private practice to the prevalence reported from the two largest national database studies. A literature review was performed to determine optimal treatment guidelines. The results of the comparison indicated that the prevalence of postirradiation angiosarcoma seen in our practice was significantly higher than that reported in the two national database studies at p‐values of 0.0124 and 0.0080. Also, results from the literature review suggest that early detection and aggressive treatment lead to improved outcomes. The data are insufficient to draw firm conclusions, but suggest that the current literature underestimates the prevalence of angiosarcoma following breast‐conserving therapy. Since elderly women derive less benefit from radiation and may be more prone to develop postirradiation angiosarcoma, confirmation of our findings could lead to a reappraisal of the management of elderly patients with early stage breast cancer. </abstract><subject lang="en"><genre>keywords</genre><topic>angiosarcoma</topic><topic>breast‐conserving therapy</topic><topic>breast neoplasm</topic><topic>lymphedema</topic><topic>radiotherapy adverse effects</topic></subject><relatedItem type="host"><titleInfo><title>The Breast Journal</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1075-122X</identifier><identifier type="eISSN">1524-4741</identifier><identifier type="DOI">10.1111/(ISSN)1524-4741</identifier><identifier type="PublisherID">TBJ</identifier><part><date>2005</date><detail type="volume"><caption>vol.</caption><number>11</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>115</start><end>123</end><total>9</total></extent></part></relatedItem><identifier type="istex">37B66C90E66D89BE9629C41D670B4168CC7381B0</identifier><identifier type="DOI">10.1111/j.1075-122X.2005.21548.x</identifier><identifier type="ArticleID">TBJ21548</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Science Inc</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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