Surgical management of radiation-associated cutaneous breast angiosarcoma

J Plast Reconstr Aesthet Surg. 2011 Aug;64(8):1036-42. doi: 10.1016/j.bjps.2011.02.014. Epub 2011 Mar 5.

Abstract

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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / etiology
  • Breast Neoplasms / mortality
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery*
  • Female
  • Hemangiosarcoma / etiology
  • Hemangiosarcoma / mortality
  • Hemangiosarcoma / surgery*
  • Humans
  • Mastectomy
  • Middle Aged
  • Muscle, Skeletal / transplantation
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / surgery
  • Neoplasms, Radiation-Induced / mortality
  • Neoplasms, Radiation-Induced / surgery*
  • Skin Neoplasms / etiology
  • Skin Neoplasms / mortality
  • Skin Neoplasms / surgery*
  • Skin Transplantation
  • Surgical Flaps