Surgical management of radiation-associated cutaneous breast angiosarcoma

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 64; no. 8; pp. 1036 - 1042
• Main Authors: Lindford, A, Böhling, T, Vaalavirta, L, Tenhunen, M, Jahkola, T, Tukiainen, E
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-08-2011; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Breast cancer; Breast Neoplasms - etiology; Breast Neoplasms - mortality; Breast Neoplasms - radiotherapy; Breast Neoplasms - surgery; Female; Gynecology. Andrology. Obstetrics; Hemangiosarcoma - etiology; Hemangiosarcoma - mortality; Hemangiosarcoma - surgery; Humans; Mammary gland diseases; Mastectomy; Medical sciences; Middle Aged; Muscle, Skeletal - transplantation; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - surgery; Neoplasms, Radiation-Induced - mortality; Neoplasms, Radiation-Induced - surgery; Plastic Surgery; Radiotherapy; Sarcoma; Skin Neoplasms - etiology; Skin Neoplasms - mortality; Skin Neoplasms - surgery; Skin Transplantation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps; Tumors; Sarcoma; Radiotherapy; Breast cancer; Breast disease; Cardiovascular disease; Malignant tumor; Angiosarcoma; Vascular disease; Mammary gland diseases; Ionizing radiation; Clinical management; Treatment; Surgery; Breast; Skin; Mammary gland; Cancer
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2011.02.014

Summary The purpose of this study was to investigate the surgical management of radiation-associated cutaneous breast angiosarcoma with an emphasis on surgical margins and choice of reconstruction. Nine cases of angiosarcoma were identified in patients earlier treated with radiotherapy for breast cancer. Breast angiosarcoma was diagnosed a median of 5.25 years following radiotherapy. Median age at diagnosis was 60 years. Surgical treatment consisted of radical mastectomy (four cases), simple mastectomy (two cases) and wide local excision (three cases). Defect reconstruction involved three latissimus dorsi flap reconstructions and four skin grafts. Clear histological margins were achieved in all cases. Median follow-up was 81 months. Six patients were alive and disease-free at the end of the study period. Aggressive surgical resection with wide margins is essential to reduce local recurrence and improve survival.