Impact of specialist management on survival from radiation‐associated angiosarcoma of the breast. BJS 2018; 105: 401-409.
Published: 6th February 2018
Authors: L. Feinberg, A. Srinivasan, J. K. Singh, M. Parry, J. Stevenson, L. Jeys et al.
Radiation‐associated angiosarcoma of the breast (RAAS) is a rare complication of adjuvant radiotherapy associated with poor survival. The British Sarcoma Group guidelines recommend that all angiosarcomas are referred to a sarcoma multidisciplinary team, although there is no recommendation that patients are managed within a sarcoma service. The aims of this study were to compare survival, complete excision rates and local recurrence rates of patients managed within a sarcoma service and those managed within local hospitals.
All patients with RAAS referred to a regional sarcoma service between 1998 and 2015 were identified from prospective databases. Patient records, and radiology, pathology and operation notes were reviewed retrospectively.
Thirty‐six patients were operated on with curative intent; 26 were managed by the sarcoma service (of whom 21 underwent radical excision of the irradiated field followed by chest wall reconstruction) and ten were managed locally. Median age was 69·5 (range 43–85) years. Disease‐specific survival was significantly longer in patients managed by the sarcoma service than in those managed locally: median 91·1 (range 69·2–113·0)
Specialist management of RAAS leads to fewer local recurrences and improved disease‐specific survival. Early referral and management within specialist units is recommended.Full text
You may also be interested in
Population‐based study of the effect of preoperative breast MRI on the surgical management of ductal carcinoma in situ.
Authors: K. B. I. M. Keymeulen, S. M. E. Geurts, M. B. I. Lobbes, E. M. Heuts, L. E. M. Duijm, L. F. S. Kooreman et al.
Nationwide population‐based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy.
Authors: E. Heeg, J. X. Harmeling, B. E. Becherer, P. J. Marang‐van de Mheen, M. T. F. D. Vrancken Peeters, M. A. M. Mureau et al.
International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy. BJS 2019; 106: 1327-1340.
Authors: M. B. Nava, J. R. Benson, W. Audretsch, P. Blondeel, G. Catanuto, M. W. Clemens et al.
Prognostic impact of repeat sentinel lymph node biopsy in patients with ipsilateral breast tumour recurrence. BJS 2019; 106: 574-585.
Authors: I. G. M. Poodt, G. Vugts, R. J. Schipper, R. M. H. Roumen, H. J. T. Rutten, A. J. G. Maaskant‐Braat et al.
Notes: No impact
Effect of preoperative injection of superparamagnetic iron oxide particles on rates of sentinel lymph node dissection in women undergoing surgery for ductal carcinoma in situ (SentiNot study). BJS 2019; 106: 720-728.
Authors: A. Karakatsanis, A.‐F. Hersi, L. Pistiolis, R. Olofsson Bagge, P. M. Lykoudis, S. Eriksson et al.
Short‐term cost‐effectiveness of one‐stage implant‐based breast reconstruction with an acellular dermal matrix versus two‐stage expander‐implant reconstruction from a multicentre randomized clinical trial. BJS 2019; 106: 586-595.
Authors: V. L. Negenborn, J. M. Smit, R. E. G. Dikmans, H. A. H. Winters, J. W. R. Twisk, P. Q. Ruhé et al.
Autologous fat transplantation alters gene expression patterns related to inflammation and hypoxia in the irradiated human breast. BJS 2019; 106: 563-573.
Authors: A. Lindegren, I. Schultz, I. Sinha, L. Cheung, A. A. Khan, M. Tekle et al.
Notes: Effects on fibrosis after radiotherapy
Authors: F. Magnoni, G. Massari, G. Santomauro, V. Bagnardi, E. Pagan, G. Peruzzotti et al.
Authors: Y. Grant, R. Al‐Khudairi, E. St John, M. Barschkett, D. Cunningham, R. Al‐Mufti et al.
Notes: Reoperations expensive
Meta‐analysis of sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with initial biopsy‐proven node‐positive breast cancer. BJS 2018; 105: 1541-1552.
Authors: S. R. Tee, L. A. Devane, D. Evoy, J. Rothwell, J. Geraghty, R. S. Prichard et al.
Notes: In selected patients using dual tracer
Feasibility study of combined dynamic imaging and lymphaticovenous anastomosis surgery for breast cancer‐related lymphoedema. BJS 2019; 106: 100-110.
Authors: A. A. Khan, I. Hernan, J. A. Adamthwaite, K. W. D. Ramsey
Notes: Effective in selected patients
Randomized clinical trial
INTEND II randomized clinical trial of intraoperative duct endoscopy in pathological nipple discharge. BJS 2018; 105: 1583-1590.
Authors: G. Gui, A. Agusti, D. Twelves, S. Tang, M. Kabir, C. Montgomery et al.
Notes: Identifies causative lesion