Radiation-associated angiosarcoma of the breast: consider chemotherapy

Area of Science:

• Oncology
• Surgical Oncology
• Radiotherapy

Background:

• Radiation-associated angiosarcoma (RAAS) is a rare secondary breast cancer post-radiotherapy.
• Prognosis and surgical outcomes for RAAS are often poorly understood and unsatisfactory.

Purpose of the Study:

• To investigate the impact of neoadjuvant chemotherapy (NAC) on breast RAAS.
• To refine prognostic factors for breast RAAS.
• To assess the effect of NAC on breast RAAS outcomes.

Main Methods:

• Analysis of M0 patients who underwent surgery for breast RAAS.
• Identification of prognostic factors for overall survival (OS), time to distant progression (TTDP), and time to loco-regional progression (TTLP).
• Comparison of surgery alone (S) versus NAC followed by surgery (NAC + S) using Cox regression and propensity score modeling.

Main Results:

• Median follow-up was 5.5 years; 5-year OS rate was 50%.
• Local recurrence (TTLP 68%) was more common than distant metastases (TTDP 36%).
• TTLP was significantly better with NAC + S (53%) compared to S alone (30%, p=0.03), with age also being a predictor.

Conclusions:

• Neoadjuvant chemotherapy followed by surgery demonstrates superior local control for breast RAAS compared to surgery alone.
• This treatment sequence may enhance patient quality of life by improving local disease management.