Primary Angiosarcoma of the Breast
摘要
Introduction: Primary breast sarcomas are rare tumors that account for less than 1% of primary breast neoplasms. Angiosarcoma is predominantly found in breast sarcomas. Angiosarcoma is an aggressive malignancy in which malignant cells express the properties of endothelial cells. Because of its rarity, the management and outcome of angiosarcoma patients has not been clearly described. In the past 20 years, there have been only two primary breast angiosarcomas treated in our hospital. Materials and Methods: Here we report on two cases of primary breast angiosarcoma with different presentations and treatment strategies. One underwent total mastectomy followed by adjuvant radiotherapy. The other one underwent modified radical mastectomy with axillary lymph node dissection. Result: The prognosis for primary breast sarcoma is highly dependent on the tumor size; higher grade and positive margins increase the risk of local recurrence and thus a decreased survival rate. One patient completed the adjuvant radiotherapy in January 2008 because of the larger tumor bed. The other one underwent surgery only due to the fact that the small lesion was still disease-free after almost 3 years. Conclusion: The treatment of choice for angiosarcoma is surgery with adequate margins. Axillary dissection is not indicated because nodal metastasis is rare. The definitive role of adjuvant therapy remains undetermined. Due to the high locoregional recurrent rate of this disease, local therapy should be optimized with multimodality treatment. Chemotherapy and radiotherapy may play an important role in survival.