[Hemangiosarcoma after breast-conserving therapy of breast cancer: report of four cases with molecular genetic diagnosis and literature review]

Strahlenther Onkol. 2011 Oct;187(10):656-64. doi: 10.1007/s00066-011-2251-5. Epub 2011 Aug 16.
[Article in German]

Abstract

Background: Hemangiosarcomas of the breast represent a rare disease of the breast mainly occurring as secondary neoplasias with a latency of 5-10 years after primary treatment of breast cancer and are associated with an unfavourable prognosis. Radiation therapy, which is integrated within the concept of breast conserving therapy ranks as the main risk factor.

Patients and methods: In this report we describe the clinical course of 4 patients including their molecular genetic pattern and give a summary of the actual literature.

Results: Hemangiosarcomas occur as a secondary neoplasm with a latency of 5-10 years after primary treatment of breast cancer and have an unfavorable prognosis. A genetic predisposition is assumed, but we could not find a significant role of tumor suppressor genes BRCA1, BRCA2 or p53 in our patients.

Conclusion: Due to limited data available for these tumors, recommendations for therapy include radical tumor resection achieving wide free margins and inconsistent regimens of chemo- and/or immunetherapy modalities. In the majority these are based on systemic therapy regimens for other cutaneous sarcomas, such as Kaposi's sarcoma. Efforts should be taken for a nation-wide systematic registration of all cases of post-irradiation hemangiosarcomas.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • BRCA2 Protein / genetics
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery*
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • DNA Mutational Analysis
  • Diagnosis, Differential
  • Fatal Outcome
  • Female
  • Genes, Suppressor*
  • Hemangiosarcoma / diagnosis*
  • Hemangiosarcoma / genetics*
  • Humans
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / genetics
  • Neoplasms, Radiation-Induced / diagnosis*
  • Neoplasms, Radiation-Induced / genetics*
  • Neoplasms, Second Primary / diagnosis*
  • Neoplasms, Second Primary / genetics*
  • Pathology, Molecular*
  • Radiotherapy, Adjuvant / adverse effects
  • Surgical Flaps
  • Tumor Suppressor Protein p53 / genetics
  • Ubiquitin-Protein Ligases / genetics

Substances

  • BRCA2 Protein
  • BRCA2 protein, human
  • Tumor Suppressor Protein p53
  • BRAP protein, human
  • Ubiquitin-Protein Ligases