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Published on: June 1, 2019
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Does Angiosarcoma of the Breast Need Nodal Staging?
Joshua Herb1, Ugwuji N Maduekwe2, Neha Goel3
1From the Department of Surgery (Herb, Spanheimer), University of North Carolina, Chapel Hill, NC.
Journal of the American College of Surgeons
|April 15, 2022
Summary
In patients with nonmetastatic breast angiosarcoma, 5% had positive lymph nodes, which is linked to significantly worse survival. This finding suggests regional lymph node evaluation is crucial for these rare cancers.
Area of Science:
- Oncology
- Surgical Pathology
- Epidemiology
Background:
- Breast angiosarcoma is a rare cancer.
- It typically spreads through the bloodstream.
- The role of lymph node involvement in survival is unclear.
Purpose of the Study:
- To determine the frequency of lymph node metastasis in nonmetastatic breast angiosarcoma.
- To investigate the association between lymph node positivity and survival.
Main Methods:
- Utilized the National Cancer Database (2004-2017).
- Identified 991 patients with nonmetastatic, resected breast angiosarcoma.
- Analyzed survival using Kaplan-Meier and Cox proportional hazard models.
Main Results:
- 30% of patients had regional lymph node evaluation.
- 5% of evaluated patients had positive lymph nodes.
- Positive lymph nodes were associated with significantly worse overall survival (HR 3.20).
Conclusions:
- A 5% regional lymph node positivity rate in nonmetastatic breast angiosarcoma warrants nodal evaluation.
- Nodal positivity identifies patients with poor survival outcomes.
- Further research on sentinel lymph node biopsy is recommended.
