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
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
Aesthetic outcome following breast‐conserving surgery assessed by three evaluation modalities in relation to health‐related quality of life. BJS 2019; 106: 90-99.
Authors: C. Dahlbäck, A. Ringberg, J. Manjer
Notes: Better methods needed
Current practice and short‐term outcomes of therapeutic mammaplasty in the international TeaM multicentre prospective cohort study. BJS 2018; 105: 1778-1792.
Authors: R. L. O'Connell, E. Baker, A. Trickey, T. Rattay, L. Whisker, R. D. Macmillan et al.
Notes: Reduces mastectomy rates
Nationwide population‐based study of trends and regional variation in breast‐conserving treatment for breast cancer. BJS 2018; 105: 1768-1777.
Authors: M. C. van Maaren, L. J. A. Strobbe, L. B. Koppert, P. M. P. Poortmans, S. Siesling
Notes: Regional differences remain
Survival and risk of breast cancer recurrence after breast reconstruction with deep inferior epigastric perforator flap. BJS 2018; 105: 1446-1453.
Authors: A. Svee, M. Mani, K. Sandquist, T. Audolfsson, Y. Folkvaljon, A. E. Isern et al.
Best‐practice care pathway for improving management of mastitis and breast abscess. BJS 2018; 105: 1615-1622.
Authors: N. Patani, F. MacAskill, S. Eshelby, A. Omar, A. Kaura, K. Contractor et al.
Notes: Outcomes improve
Meta‐analysis of the cumulative risk of endometrial malignancy and systematic review of endometrial surveillance in extended tamoxifen therapy. BJS 2018; 105: 1098-1106.
Authors: C. A. Fleming, H. M. Heneghan, D. O'Brien, D. P. McCartan, E. W. McDermott, R. S. Prichard et al.
Notes: Counselling of patients important
Meta‐analysis of the diagnostic accuracy of ultrasound‐guided fine‐needle aspiration and core needle biopsy in diagnosing axillary lymph node metastasis. BJS 2018; 105: 1244-1253.
Authors: I. Balasubramanian, C. A. Fleming, M. A. Corrigan, H. P. Redmond, M. J. Kerin, A. J. Lowery et al.
Notes: Core needle biopsy better
Breast‐conserving surgery followed by whole‐breast irradiation offers survival benefits over mastectomy without irradiation. BJS 2018; 105: 1607-1614.
Authors: J. de Boniface, J. Frisell, L. Bergkvist, Y. Andersson
Notes: Radiotherapy to lower axilla key?