Cutaneous angiosarcoma following breast-conserving surgery and radiation: an analysis of 27 cases.
Identifieur interne : 008830 ( Main/Exploration ); précédent : 008829; suivant : 008831Cutaneous angiosarcoma following breast-conserving surgery and radiation: an analysis of 27 cases.
Auteurs : Steven D. Billings [États-Unis] ; Jesse K. Mckenney ; Andrew L. Folpe ; Michael C. Hardacre ; Sharon W. WeissSource :
- The American journal of surgical pathology [ 0147-5185 ] ; 2004.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Complications postopératoires, Enfant, Femelle, Humains, Hémangiosarcome (), Hémangiosarcome (anatomopathologie), Hémangiosarcome (mortalité), Hémangiosarcome (étiologie), Lymphoedème (), Mastectomie, Mastectomie partielle, Mitose, Métastase tumorale, Radiothérapie adjuvante (effets indésirables), Récidive tumorale locale, Seconde tumeur primitive (étiologie), Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs cutanées (), Tumeurs cutanées (anatomopathologie), Tumeurs cutanées (mortalité), Tumeurs cutanées (étiologie).
- MESH :
- anatomopathologie : Hémangiosarcome, Tumeurs cutanées.
- effets indésirables : Radiothérapie adjuvante.
- mortalité : Hémangiosarcome, Tumeurs cutanées.
- étiologie : Hémangiosarcome, Seconde tumeur primitive, Tumeurs cutanées.
- Adulte d'âge moyen, Complications postopératoires, Enfant, Femelle, Humains, Hémangiosarcome, Lymphoedème, Mastectomie, Mastectomie partielle, Mitose, Métastase tumorale, Récidive tumorale locale, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs cutanées.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Child, Female, Hemangiosarcoma (etiology), Hemangiosarcoma (mortality), Hemangiosarcoma (pathology), Hemangiosarcoma (surgery), Humans, Lymphedema (complications), Mastectomy, Mastectomy, Segmental, Middle Aged, Mitosis, Neoplasm Metastasis, Neoplasm Recurrence, Local, Neoplasms, Second Primary (etiology), Postoperative Complications, Radiotherapy, Adjuvant (adverse effects), Skin Neoplasms (etiology), Skin Neoplasms (mortality), Skin Neoplasms (pathology), Skin Neoplasms (surgery).
- MESH :
- adverse effects : Radiotherapy, Adjuvant.
- complications : Lymphedema.
- etiology : Hemangiosarcoma, Neoplasms, Second Primary, Skin Neoplasms.
- mortality : Hemangiosarcoma, Skin Neoplasms.
- pathology : Hemangiosarcoma, Skin Neoplasms.
- surgery : Hemangiosarcoma, Skin Neoplasms.
- Aged, Aged, 80 and over, Child, Female, Humans, Mastectomy, Mastectomy, Segmental, Middle Aged, Mitosis, Neoplasm Metastasis, Neoplasm Recurrence, Local, Postoperative Complications.
Abstract
Iatrogenic angiosarcomas (AS), following treatment of breast carcinomas and attributed to chronic lymphedema, were first described by Stewart and Treves. With emphasis on breast-conserving therapy combined with adjuvant radiation, a recently recognized form of cutaneous postradiation angiosarcoma of the breast (CPRASB) has emerged. To more completely characterize CPRASB, 27 cases were analyzed. Histologic features studied included pattern of growth (vasoformative, sieve-like, or solid), nuclear grade, necrosis, and mitotic rate. Clinical and follow-up information was obtained. The patients received relatively standard radiation treatment. The median interval to diagnosis of CPRASB was 59 months; 5 occurred in less than 3 years. Lymphedema was largely absent, and when present was only mild in nature. CPRASB was frequently multifocal at presentation (13 of 27). All tumors had a vasoformative pattern of growth; the majority (16 of 27) had areas with a sieve-like pattern. The solid pattern was less frequent (7 of 27). The majority had high-grade nuclear features (16 grade 3, 8 grade 2, 3 grade1). The mean mitotic rate was 9/10 HPF. Necrosis was rare (2 of 27). All were treated with wide excision or mastectomy. Follow-up was available on 22 of 27 cases (median 44 months). Fourteen experienced local recurrence and 6 had multiple recurrences. Metastasis was documented in 9 of 22 patients and involved lungs (6), contralateral breast (3), skeleton (2), lymph nodes (1), and soft tissue (1). Eight patients died of disease, 2 died with disease, 4 were alive with disease, and 8 are alive without disease. The median interval to death was 33.5 months. All 4 patients with disease have documented metastasis. CPRASB differs from Stewart-Treves AS by its shorter latency period and lack of association with lymphedema.
PubMed: 15166670
Affiliations:
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Le document en format XML
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Billings</name><affiliation wicri:level="2"><nlm:affiliation>Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA. sdbillin@iupui.edu</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202</wicri:regionArea><placeName><region type="state">Indiana</region></placeName></affiliation></author><author><name sortKey="Mckenney, Jesse K" sort="Mckenney, Jesse K" uniqKey="Mckenney J" first="Jesse K" last="Mckenney">Jesse K. Mckenney</name></author><author><name sortKey="Folpe, Andrew L" sort="Folpe, Andrew L" uniqKey="Folpe A" first="Andrew L" last="Folpe">Andrew L. Folpe</name></author><author><name sortKey="Hardacre, Michael C" sort="Hardacre, Michael C" uniqKey="Hardacre M" first="Michael C" last="Hardacre">Michael C. Hardacre</name></author><author><name sortKey="Weiss, Sharon W" sort="Weiss, Sharon W" uniqKey="Weiss S" first="Sharon W" last="Weiss">Sharon W. Weiss</name></author></analytic><series><title level="j">The American journal of surgical pathology</title><idno type="ISSN">0147-5185</idno><imprint><date when="2004" type="published">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Child</term><term>Female</term><term>Hemangiosarcoma (etiology)</term><term>Hemangiosarcoma (mortality)</term><term>Hemangiosarcoma (pathology)</term><term>Hemangiosarcoma (surgery)</term><term>Humans</term><term>Lymphedema (complications)</term><term>Mastectomy</term><term>Mastectomy, Segmental</term><term>Middle Aged</term><term>Mitosis</term><term>Neoplasm Metastasis</term><term>Neoplasm Recurrence, Local</term><term>Neoplasms, Second Primary (etiology)</term><term>Postoperative Complications</term><term>Radiotherapy, Adjuvant (adverse effects)</term><term>Skin Neoplasms (etiology)</term><term>Skin Neoplasms (mortality)</term><term>Skin Neoplasms (pathology)</term><term>Skin Neoplasms (surgery)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Complications postopératoires</term><term>Enfant</term><term>Femelle</term><term>Humains</term><term>Hémangiosarcome ()</term><term>Hémangiosarcome (anatomopathologie)</term><term>Hémangiosarcome (mortalité)</term><term>Hémangiosarcome (étiologie)</term><term>Lymphoedème ()</term><term>Mastectomie</term><term>Mastectomie partielle</term><term>Mitose</term><term>Métastase tumorale</term><term>Radiothérapie adjuvante (effets indésirables)</term><term>Récidive tumorale locale</term><term>Seconde tumeur primitive (étiologie)</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs cutanées ()</term><term>Tumeurs cutanées (anatomopathologie)</term><term>Tumeurs cutanées (mortalité)</term><term>Tumeurs cutanées (étiologie)</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Radiotherapy, Adjuvant</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Hémangiosarcome</term><term>Tumeurs cutanées</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Radiothérapie adjuvante</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Hemangiosarcoma</term><term>Neoplasms, Second Primary</term><term>Skin Neoplasms</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Hemangiosarcoma</term><term>Skin Neoplasms</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Hémangiosarcome</term><term>Tumeurs cutanées</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Hemangiosarcoma</term><term>Skin Neoplasms</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Hemangiosarcoma</term><term>Skin Neoplasms</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Hémangiosarcome</term><term>Seconde tumeur primitive</term><term>Tumeurs cutanées</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Child</term><term>Female</term><term>Humans</term><term>Mastectomy</term><term>Mastectomy, Segmental</term><term>Middle Aged</term><term>Mitosis</term><term>Neoplasm Metastasis</term><term>Neoplasm Recurrence, Local</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Complications postopératoires</term><term>Enfant</term><term>Femelle</term><term>Humains</term><term>Hémangiosarcome</term><term>Lymphoedème</term><term>Mastectomie</term><term>Mastectomie partielle</term><term>Mitose</term><term>Métastase tumorale</term><term>Récidive tumorale locale</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs cutanées</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Iatrogenic angiosarcomas (AS), following treatment of breast carcinomas and attributed to chronic lymphedema, were first described by Stewart and Treves. With emphasis on breast-conserving therapy combined with adjuvant radiation, a recently recognized form of cutaneous postradiation angiosarcoma of the breast (CPRASB) has emerged. To more completely characterize CPRASB, 27 cases were analyzed. Histologic features studied included pattern of growth (vasoformative, sieve-like, or solid), nuclear grade, necrosis, and mitotic rate. Clinical and follow-up information was obtained. The patients received relatively standard radiation treatment. The median interval to diagnosis of CPRASB was 59 months; 5 occurred in less than 3 years. Lymphedema was largely absent, and when present was only mild in nature. CPRASB was frequently multifocal at presentation (13 of 27). All tumors had a vasoformative pattern of growth; the majority (16 of 27) had areas with a sieve-like pattern. The solid pattern was less frequent (7 of 27). The majority had high-grade nuclear features (16 grade 3, 8 grade 2, 3 grade1). The mean mitotic rate was 9/10 HPF. Necrosis was rare (2 of 27). All were treated with wide excision or mastectomy. Follow-up was available on 22 of 27 cases (median 44 months). Fourteen experienced local recurrence and 6 had multiple recurrences. Metastasis was documented in 9 of 22 patients and involved lungs (6), contralateral breast (3), skeleton (2), lymph nodes (1), and soft tissue (1). Eight patients died of disease, 2 died with disease, 4 were alive with disease, and 8 are alive without disease. The median interval to death was 33.5 months. All 4 patients with disease have documented metastasis. CPRASB differs from Stewart-Treves AS by its shorter latency period and lack of association with lymphedema.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Indiana</li></region></list><tree><noCountry><name sortKey="Folpe, Andrew L" sort="Folpe, Andrew L" uniqKey="Folpe A" first="Andrew L" last="Folpe">Andrew L. Folpe</name><name sortKey="Hardacre, Michael C" sort="Hardacre, Michael C" uniqKey="Hardacre M" first="Michael C" last="Hardacre">Michael C. Hardacre</name><name sortKey="Mckenney, Jesse K" sort="Mckenney, Jesse K" uniqKey="Mckenney J" first="Jesse K" last="Mckenney">Jesse K. Mckenney</name><name sortKey="Weiss, Sharon W" sort="Weiss, Sharon W" uniqKey="Weiss S" first="Sharon W" last="Weiss">Sharon W. Weiss</name></noCountry><country name="États-Unis"><region name="Indiana"><name sortKey="Billings, Steven D" sort="Billings, Steven D" uniqKey="Billings S" first="Steven D" last="Billings">Steven D. Billings</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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