Page 18 - Delaware Medical Journal - March 2016

however local recurrence rates are still very high. The role of

center prospective will be needed; however, the small number
of cases makes this prohibitive. Brachytherapy may become a more attractive option for radiation if decreased rates of RAAS
are demonstrated in this patient population. Genetic testing and potential targeted therapies are emerging as an option for treatment and prevention of this complicated disease process.
REFERENCES
1. Fisher B, Bauer M, Margolese R, et al. Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med. 1985;312:665-673.
2. Veronesi U, Saccozzi R, Del Vecchio M, et al. Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of breast. N Engl J Med. 1981;305:6-11.
3. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233-1241.
4. Styring E, Fernebro J, Jonsson, PE, et al. Changing clinical presentation of angiosarcomas after breast cancer: from late tumors in edematous arms to earlier tumors on the thoracic wall. Breast Cancer Res Treat. 2010;122;883-887.
5. Kiluk JV, Yeh KA. Primary angiosarcoma of the breast. Breast J. 2005;11:517-18.
6. Body G, Sauvantet E, Calais G, et al. Cutaneous angiosarcoma of the breast following surgery and irradiation of breast adenocarcinoma.
J Gynecol Obstet Biol Reprod. 1987;16:479-483.
7. Scow J, Reynolds C, Degnim A, et al. Primary and secondary angiosarcoma of the breast: The mayo clinic experience. J Surg Onc. 2010;101:401-407.
8. Yap J, Chuba PJ, Thomas R, et al. Sarcoma as a second malignancy after treatment for breast cancer. Int J Radiat Onco Biol Phys. 2002;52:1231-7.
9. Tomasini C, Grassi M, Pippione M. Cutaneous angiosarcoma arising in an irradiated breast. Dermatology. 2004;209:208-214.
10. Fraga-Guedes C, Gobbi H, Mastropasqua MG, et al. Primary and secondary angiosarcomas of the breast: a single institution experience. Breast Cancer Res Treat. 2012;132:1081-1088.
11. Vorburger SA, Xing Y, Hunt KK, et al. Angiosarcoma of the breast. Cancer. 2005;104:2682-2688.
12. Torres KE, Ravi V, Kin K, et al. Long-term outcomes in patients with radiation-associated angiosarcomas of the breast following surgery and radiotherapy for breast cancer. Ann Surg Onc. 2013;20:1267-1274.
13. Depla AL, Scharloo-Karels CH, De Jong MA, et al. Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer: a systemic review. Euro J Cancer. 2014;50:1779-1788.
14. Marchal C, Weber B, de Lafontan B, et al. Nine breast angiosarcomas after conservative treatment of breast carcinoma: a survey from French comprehensive cancer centers. Int J Radiat Oncol Biol Phys. 1999;44:113-119.
15. Edge SB, Byrd DR, Compton CC, et al. AJCC: Soft Tissue Sarcoma. New York: Springer, 2010.
CONTRIBUTING AUTHORS
■ IAN N. WILHELM, MD is a fourth-year General Surgery Resident at Christiana Care Health System in Newark, Del.
■ EMILY J. PENMAN, MD is the Medical Director of the Breast Center at the Helen F. Graham Cancer Center in Newark, Del. and Associate Vice Chair of the Department of Surgery and Medical Director of Operating Rooms for Christiana Care Health Center in Newark, Del.
16. Smith TL, Morris CG, and Mendenhall NP. Angiosarcoma after breast- conserving therapy; Long-term disease control and late effects with hyperfractionated accelerated re-irradiation (HART). Acta Oncol. 2014;53:235-241.
17.
18.
19.
20. 21. 22.
23.
24.
25. 26.
27.
28.
29.
30.
Rao J, Dekoven JG, Beatty JD, et al. Cutaneous angiosarcoma as a delayed complication of radiation therapy for carcinoma of the breast. J Am Acad Dermatol. 2003;49:532-538.
Plotti F, Di Donato V, Zullo MA et al. An unusual case of secondary fibrosarcoma after treatment for breast cancer. Gynecol Oncol. 2006;103:1133-1136.
Borman H, Safak T, Ertoy D. Fibrosarcoma following radiotherapy for breast carcinoma: A case report and review of the literature. Ann Plast Surg. 1998;41:201-204.
Fant J, Grant M, May S et al. Angiosarcoma of the breast: mammographic, clinical, and pathologic correlations. Breast J. 2003;9:252-253.
Thijssens KM, van Ginkel RJ, Suurmeijer AJ, et al. Radiation-induced sarcoma: a challenge for the surgeon. Ann Surg Oncol. 2005;12:237-245.
Seinen JM, Styring E, Verstappen V, et al. Radiation-Associated angiosarcoma after breast cancer: high recurrence rate and poor survival despite surgical treatment with R0 Resection. Ann Surg Onc. 2012;19:2700-2701.
Barrow BJ, Janjan NA, Gutman H, et al. Role of radiotherapy in sarcoma of the breast-a retrospective review of the M.D. Anderson experience. Radiother Oncol. 1999;52:173-178.
Ghareeb E, Bhargava R, Vargo JA, et al. Primary and radiation-induced breast angiosarcoma: clinicopathologic predictors of outcomes and the impact of adjuvant radiation therapy. Am J Clin Onc. 2014;Dec.17.
Palta M, Morris CG, Grobmyer SR, et al. Angiosarcoma after breast conserving therapy. Cancer. 2010;116:1872-1878.
De Jong MA, Oldenbord S, Bing Oei S, et al. Reirradiation and hyperthermia for radiation associated sarcoma. Cancer. 2012;118:180-187
Penel N, Bui BN, Bay JO, et al. Phase II trial of weekly paclitaxel for unresectable angiosarcoma: the ANGIOTAX Study. J Clin Oncol. 2008;26:5269-5274.
Mentzel T, Schildhaus HU, Palmedo G, et al. Postradiation cutaneous angiosarcoma after treatment of breast carcinoma is characterized
by MYC amplification in contrast to atypical vascular lesions after radiotherapy and control cases: clinicopathological immunohistochemical and molecular analysis of 66 cases. Mod Path. 2012;25:75-85.
Cornejo KM, Deng A, Wu H, et al. The utility of MYC and FLT4 in the diagnosis and treatment of postradiation atypical vascular lesion and angiosarcoma of the breast. Human Path. 2015;46:868-875.
Wade MA, May F, Onel K, et al. Does radiation-induced c-MYC amplification initiate breast oncogenesis? Mol Cell Onc. DOI: 10.1080/23723556.2015.1010950.
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