Angiosarcoma of the breast represents 1% of all soft tissue
breast tumors. With breast-conserving
therapy (BCT) as standard in the last three decades, a new type of
angiosarcoma has been reported: post-irradiation
angiosarcoma (PIAS). A recent study based on the SEER database found an absolute risk for PIAS of seven per 100,000 person-years for BCT patients. We present a retrospective analysis of the clinical characteristics, treatment, and outcome of six cases of PIAS treated in our institution from 1995 to 2010. Mean age at diagnosis of
breast cancer was 68 years (range 54-76 years). All patients underwent BCT.
Adjuvant radiotherapy was given to all patients at doses of 45-50 Gy. Mean time from
adjuvant radiotherapy to PIAS was 9.2 years (range 5.3-13.8 years); median follow-up from diagnosis of PIAS was 41.8 months (range 11-102 months). At diagnosis of PIAS, mean age of patients was 78 years (range 63-87 years). All patients underwent
simple mastectomy, following which one patient received
chemotherapy with
doxorubicin and three patients received
radiation therapy. Two patients developed local recurrence, one concurrent with metastatic disease. Another patient was diagnosed after 24 months with extensive
small cell lung cancer and died of disease without recurrence of PIAS. Four patients are alive without evidence of recurrence. PIAS is a very rare
sarcoma occurring after BCT. Careful observation after
adjuvant radiotherapy is required. Standard treatment is the surgery with
simple mastectomy and
adjuvant radiotherapy;
chemotherapy may be considered for more advanced cases.