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Radiation Oncology: Updates, Innovations & Controversies

(P 309) CLINICAL PATHOLOGICAL CHARACTERISTICS, PATTERN OF CARE AND SURVIVAL OF NON-METASTATIC BREAST ANGIOSARCOMA

Location: The Liffey, Level 1

    Author(s)

  • Daniela Greto, MD

    Medical Doctor
    Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
    Florence, Toscana, Italy

    • Co-Author(s)

  • ML

    Mauro Loi, MD (he/him/his)

    Clinical Consultant
    Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
    Florence, Toscana, Italy

  • IM

    Icro Meattini, MD

    Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
    Florence, Toscana, Italy

  • IB

    Ilaria Bonaparte, MD (she/her/hers)

    Resident
    Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
    Florence, Toscana, Italy

  • AP

    Annarita Palomba, MD

    Unit of Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy.
    Florence, Toscana, Italy

  • Domenico Andrea A. Campanacci, Full Professor

    Full Professor Orthopaedic Surgery
    Department of Orthopaedic Oncology and Reconstructive Surgery, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
    Florence, Toscana, Italy

  • LL

    Lorenzo Livi, Full Professor

    Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
    Florence, Toscana, Italy

Objective: Breast Angiosarcoma (BAS) is a rare soft tissue sarcoma subtype that may arise de novo or in previously irradiated patients. Due to its scarce incidence, prognostic factors and optimal pattern of care are ill-defined. The aim of this study is to investigate the clinicopathological features, treatment modalities and outcome of BAS

Methods: Clinical and treatment-related data from consecutive non-metastatic patients treated at our Institution from June 2006 to December 2020 were retrospectively reviewed. Local control (LC), Distant Metastasis-Free Survival (DMFS), Overall Survival (OS) were calculated using the Kaplan‐Meier method and compared with log‐rank test.

Results: Twenty-two patients were included in the analysis. Median age was 60 (17-86) years. In 15 patients, AS arose in a previously irradiated field following adjuvant radiotherapy of prior breast adenocarcinoma. No information on pre-existing edema were available. All patients underwent surgery consisting of wide excision and mastectomy in 6 and 16 cases respectively.Grade 3 FNCLCC disease was identified in 7 patients. Postoperative radiotherapy and chemotherapy were required in respectively 5 (median dose 60 Gy, range 25-66 Gy) and 3 patients. At the time of our analysis after a median follow-up of 36 months disease recurrence occurred as local, distant, and concurrent distant and local failure in 3, 6 and 6 patients. Three-years LC, DMFS and OS rate were 59%, 51% and 76% respectively. At statistical analysis, only deep-seated tumors were correlated with impaired DMFS (29 months vs NR, p=0.0043) and OS (29 months vs NR, p=0.001), while no correlation was found between outcome and previous irradiation.

Conclusion: BAS is characterized by poor outcomes, and may require treatment intensification with more extended surgery due to prior management and possible prognostic role of deep-seated tumor.