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Primary Angiosarcoma of Breast: Surgery Alone Versus Chemotherapy and/or Radiotherapy-A Systematic Review and
Konstantinos Skarentzos1, Anastasia Kourtesa2, Abraham Pouliakis1
1Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 12462 Athens, Greece.
Cancers
|February 27, 2026
Summary
Histologic grade is a key prognostic factor for primary angiosarcoma of the breast (PAB). Adjuvant chemotherapy significantly improves survival, while radiotherapy does not, offering crucial evidence for treatment strategies.
Area of Science:
- Oncology
- Surgical Pathology
- Clinical Oncology
Background:
- Primary angiosarcoma of the breast (PAB) is a rare cancer with undefined treatment guidelines.
- Lack of standardized protocols necessitates research into prognostic factors and treatment efficacy.
Purpose of the Study:
- To determine the impact of tumor grade on overall survival (OS) in PAB.
- To assess the association of adjuvant chemotherapy and radiotherapy with survival outcomes in PAB.
Main Methods:
- Systematic literature search of PubMed, Scopus, and Cochrane Library.
- Independent data extraction and risk of bias assessment (Newcastle-Ottawa Scale).
- Kaplan-Meier curve digitization and random-effects meta-analysis.
Main Results:
- Eleven studies (436 patients) were included.
- Higher tumor grade (Grade 2 vs. 1: HR 1.2; Grade 3 vs. 1: HR 3.7) significantly predicted mortality.
- Adjuvant chemotherapy showed a significant survival benefit (HR = 0.11), while radiotherapy did not (p = 0.96).
Conclusions:
- Histologic grade is a critical prognostic factor in PAB.
- Adjuvant chemotherapy is strongly associated with improved survival in PAB patients.
- Findings support chemotherapy in multimodal treatment for PAB and aid in risk stratification.
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