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Rincón-Riveros A, De la Peña J, Rubiano W, Olivella F, Martinez-Agüero M, Villegas VE. Primary Breast Angiosarcoma: Comparative Transcriptome Analysis. Int J Mol Sci 2022; 23:ijms232416032. [PMID: 36555675 PMCID: PMC9781631 DOI: 10.3390/ijms232416032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
Primary breast angiosarcoma, with de novo appearance and not associated with exposure to radiation or lymphedema, is a rare pathology representing less than 0.05% of the neoplasms related to this organ. The pathology is characterized by its aggressiveness, poor prognosis, and difficulties in its differential diagnosis. This article reports the case of a 55-year-old white woman with no family history of cancer, with a rapidly growing mass in the left mammary gland that ulcerates and bleeds. It is confirmed as primary breast angiosarcoma by immunostaining in the tumor tissue for CD31, CD34, and FLI-1. In addition, a sample of neoplastic and healthy tissues is collected from the patient for RNA sequencing; the results are contrasted with a tissue sample from a patient with Luminal A subtype of breast cancer, as well as data from other cases of angiosarcoma available in public databases. These findings revealed a genetic profile associated with the immune and inflammatory response in the patient's sample when compared to available angiosarcoma data; these molecular patterns are consistent with other recent studies. Due to the rarity of the disease, the studies carried out on each patient contribute to the expanding knowledge of the etiology and molecular pathways that are still partially known and continue to be the subject of research. Aside from a comparative transcriptome study, this article aims to provide an update on the state of knowledge about this disease.
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Affiliation(s)
- Andrés Rincón-Riveros
- Bioinformatics and Systems Biology Group, Universidad Nacional de Colombia, Bogotá 111221, Colombia
- Correspondence: (A.R.-R.); (V.E.V.); Tel.: +57-1-6012-418800 (ext. 281) (A.R.-R.); +57-1-6012-976200 (ext. 4029) (V.E.V.)
| | - Jairo De la Peña
- Servicio de Mastología, Hospital Universitario Mayor Méderi, Bogotá 111411, Colombia
| | - Wilson Rubiano
- Servicio de Mastología, Hospital Universitario Mayor Méderi, Bogotá 111411, Colombia
| | - Fabio Olivella
- Servicio de Mastología, Hospital Universitario Mayor Méderi, Bogotá 111411, Colombia
| | - María Martinez-Agüero
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá 111221, Colombia
| | - Victoria E. Villegas
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá 111221, Colombia
- Correspondence: (A.R.-R.); (V.E.V.); Tel.: +57-1-6012-418800 (ext. 281) (A.R.-R.); +57-1-6012-976200 (ext. 4029) (V.E.V.)
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Banks J, George J, Potter S, Gardiner MD, Ives C, Shaaban AM, Singh J, Sherriff J, Hallissey MT, Horgan K, Harnett A, Desai A, Ferguson DJ, Tillett R, Izadi D, Sadideen H, Jain A, Gerrand C, Holcombe C, Hayes A, Teoh V, Wyld L. Breast Angiosarcoma Surveillance Study: UK national audit of management and outcomes of angiosarcoma of the breast and chest wall. Br J Surg 2021; 108:388-394. [PMID: 33749771 DOI: 10.1093/bjs/znaa128] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 11/15/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Breast angiosarcomas are rare tumours of vascular origin. Secondary angiosarcoma occurs following radiotherapy for breast cancer. Angiosarcomas have high recurrence and poor survival rates. This is concerning owing to the increasing use of adjuvant radiotherapy for the treatment of invasive breast cancer and ductal cancer in situ (DCIS), which could explain the rising incidence of angiosarcoma. Outcome data are limited and provide a poor evidence base for treatment. This paper presents a national, trainee-led, retrospective, multicentre study of a large angiosarcoma cohort. METHODS Data for patients with a diagnosis of breast/chest wall angiosarcoma between 2000 and 2015 were collected retrospectively from 15 centres. RESULTS The cohort included 183 patients with 34 primary and 149 secondary angiosarcomas. Median latency from breast cancer to secondary angiosarcoma was 6 years. Only 78.9 per cent of patients were discussed at a sarcoma multidisciplinary team meeting. Rates of recurrence were high with 14 of 28 (50 per cent ) recurrences in patients with primary and 80 of 124 (64.5 per cent ) in those with secondary angiosarcoma at 5 years. Many patients had multiple recurrences: total of 94 recurrences in 162 patients (58.0 per cent). Median survival was 5 (range 0-16) years for patients with primary and 5 (0-15) years for those with secondary angiosarcoma. Development of secondary angiosarcoma had a negative impact on predicted breast cancer survival, with a median 10-year PREDICT prognostic rate of 69.6 per cent, compared with 54.0 per cent in the observed cohort. CONCLUSION A detrimental impact of secondary angiosarcoma on breast cancer survival has been demonstrated. Although not statistically significant, almost all excess deaths were attributable to angiosarcoma. The increased use of adjuvant radiotherapy to treat low-risk breast cancer and DCIS is a cause for concern and warrants further study.
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Affiliation(s)
- J Banks
- Department of Breast Surgery, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - J George
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
- Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - S Potter
- Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - M D Gardiner
- Department of Plastic Surgery, Frimley Health Foundation NHS Trust, Frimley, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - C Ives
- Department of Breast Surgery, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - A M Shaaban
- Department of Cellular Pathology, Queen Elizabeth Hospital, Birmingham, UK
- Department of Cellular Pathology, University of Birmingham, Birmingham, UK
| | - J Singh
- Department of Breast Surgery, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
| | - J Sherriff
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M T Hallissey
- Department of General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - K Horgan
- Department of General Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Harnett
- Department of Oncology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - A Desai
- Department of General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - D J Ferguson
- Department of Breast Surgery, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - R Tillett
- Department of Plastic Surgery, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - D Izadi
- Department of Plastic Surgery, Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - H Sadideen
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Jain
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Department of Plastic and Reconstructive surgery, Imperial College Healthcare NHS Trust, London, UK
| | - C Gerrand
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | - C Holcombe
- British Association of Plastic, Reconstructive and Aesthetic Surgeons, London, UK
- Linda McCartney Centre, Royal Liverpool and Broadgreen University Hospitals NHS Foundation Trust, Liverpool, UK
| | - A Hayes
- Sarcoma and Melanoma Unit, Department of Academic Surgery, Royal Marsden Hospital, London, UK
| | - V Teoh
- Sarcoma and Melanoma Unit, Department of Academic Surgery, Royal Marsden Hospital, London, UK
| | - L Wyld
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
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