Molitoris Jason K, Chhabra Arpit, Snider James W, Harvilla Nicole, Okonkwo Nkechi, Nichols Elizabeth M, Vujaskovic Zeljko, Ioffe Olga B, Kesmodel Susan B, Feigenberg Steven J
Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA.
Pathology, University of Maryland School of Medicine, Baltimore, USA.
Cureus. 2017 Jun 28;9(6):e1406. doi: 10.7759/cureus.1406.
Angiosarcoma (AS) of the breast is a rare malignancy most commonly encountered as a secondary malignancy after the treatment of breast cancer with or without adjuvant radiation. The prognosis for secondary AS is poor, with reported five-year overall survival rates ranging from 10%-43%. The establishment of local control is vital to prognosis, yet patients often die with locally progressive disease. Multiple local therapies have been employed including surgery alone, surgery followed by radiation, and concurrent radiation and hyperthermia. Here, we report a case of secondary AS that occurred after breast conserving therapy and adjuvant radiation for ductal carcinoma in situ (DCIS). After initial surgical excision and subsequent local recurrence, our patient was treated with a novel treatment intensification strategy including neoadjuvant, accelerated hyperfractionated radiation with concurrent hyperthermia, followed by total mastectomy and flap reconstruction. The final pathologic evaluation demonstrated a near-complete response to induction thermoradiotherapy.
乳腺血管肉瘤（AS）是一种罕见的恶性肿瘤，最常见于乳腺癌接受或未接受辅助放疗治疗后的继发性恶性肿瘤。继发性AS的预后较差，报道的五年总生存率为10%-43%。实现局部控制对预后至关重要，但患者常死于局部进展性疾病。已采用多种局部治疗方法，包括单纯手术、手术加放疗以及同步放疗和热疗。在此，我们报告一例导管原位癌（DCIS）保乳治疗和辅助放疗后发生的继发性AS病例。在初次手术切除及随后局部复发后，我们的患者接受了一种新的强化治疗策略，包括新辅助、加速超分割放疗并同步热疗，随后行全乳切除和皮瓣重建。最终病理评估显示对诱导热放疗接近完全缓解。
