Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Curr Oncol. 2022 May 4;29(5):3272-3281. doi: 10.3390/curroncol29050267.
Due to the rarity of primary angiosarcoma of the breast, optimal management is based on expert opinion. The aim of this study was to review all primary angiosarcomas of the breast obtained from a single center in terms of clinicopathologic characteristics, treatment, and survival outcomes. From 1997 to 2020, 15 patients with primary angiosarcoma of the breast underwent either mastectomy or wide excision. We analyzed the clinicopathologic data to assess disease-free survival and overall survival. Fifteen women with primary angiosarcoma of the breast were identified. The mean age at diagnosis was 33 years (range: 14-63 years). The overall mean tumor size was 7.7 cm (range 3.5-20 cm). Upon histological grading, there were three cases of low grade, five intermediate grade, six high grade, and one unidentified grade. The five-year disease-free survival rate was 24.4%, and the five-year survival rate was 37.2%. The survival rate of the low-grade patient group was statistically higher than that of the intermediate- or high-grade patient groups ( = 0.024). Primary angiosarcoma of the breast is a rare aggressive tumor characterized by high grade and poor outcome. Histologic grade appears to be a reliable predictor of survival. There are no standard treatment guidelines; thus, optimal R0 surgical resection remains the best approach. The roles of neoadjuvant, adjuvant chemotherapy, and radiotherapy remain unclear.
由于原发性乳腺血管肉瘤较为罕见,其最佳治疗方案主要基于专家意见。本研究旨在回顾单一中心的所有原发性乳腺血管肉瘤,分析其临床病理特征、治疗方法和生存结局。1997 年至 2020 年,15 例原发性乳腺血管肉瘤患者接受了乳房切除术或广泛切除术。我们分析了临床病理数据,以评估无病生存率和总生存率。共发现 15 例原发性乳腺血管肉瘤患者,平均诊断年龄为 33 岁(14-63 岁)。肿瘤平均最大径为 7.7cm(3.5-20cm)。组织学分级方面,低级别 3 例,中级别 5 例,高级别 6 例,1 例未分级。5 年无病生存率为 24.4%,5 年总生存率为 37.2%。低级别患者组的生存率明显高于中级别或高级别患者组( = 0.024)。原发性乳腺血管肉瘤是一种侵袭性强、罕见的肿瘤,组织学分级高,预后差。组织学分级似乎是一个可靠的生存预测指标。目前尚无标准的治疗指南,因此,R0 手术切除仍是最佳治疗方法。新辅助、辅助化疗和放疗的作用尚不清楚。