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DOI: 10.1055/s-2008-1038387
© Georg Thieme Verlag KG Stuttgart · New York
Angiosarkome nach brusterhaltender Therapie des Mammakarzinoms mit postoperativer Strahlentherapie
Angiosarcomas after Conservative Breast Surgery and Radiation Therapy for Breast CarcinomaPublication History
eingereicht 5.9.2007
revidiert 9.10. + 15.11.2007
akzeptiert 15.1.2008
Publication Date:
27 March 2008 (online)
![](https://www.thieme-connect.de/media/gebfra/200803/lookinside/thumbnails/10.1055-s-2008-1038387-1.jpg)
Zusammenfassung
Gemessen an der Häufigkeit der Anwendung einer Strahlentherapie bei der Behandlung des Mammakarzinoms ist das Auftreten eines Angiosarkoms (AS) im Bereich der Bestrahlungsfelder ein seltenes Ereignis; allerdings wird man im Wandel der operativen Therapie - von der radikalen Mastektomie zum seit nahezu 30 Jahren etablierten Standard der brusterhaltenden Therapie, Segmentresektion mit Axilladissektion in Verbindung mit der obligaten Strahlentherapie - sicherlich eine Zunahme dieser Spätfolge zu verzeichnen haben. Der Artikel stellt vier Kasuistiken aus der eigenen Praxis vor, sowie einen weiteren Fall, der gemeinsamen im onkologischen Arbeitskreis Nord diskutiert wurde, unter kritischer Würdigung der aktuellen Literatur zu dieser Thematik.
Abstract
Despite the widespread use of radiation therapy to treat breast carcinoma, the development of an angiosarcoma in the radiation therapy area is rare. Five cases of cutaneous angiosarcoma of the breast that arose in irradiated skin tissue in women who had previously undergone treatment for the breast are reported. The case reports are followed by a discussion and a review of the literature.
Schlüsselwörter
Angiosarkom - Mammakarzinom - Strahlentherapie - Spätkomplikationen der Strahlentherapie
Key words
angiosarcomas - breast carcinoma - radiation therapy - delayed complication of radiation therapy
Literatur
- 1 Cha C, Antonescu C R, Quan M L, Maru S, Brennan M F. Long-term results with resection of radiation-induced soft tissue sarcomas. Ann Surg. 2004; 239 903-910
- 2 Warren S, Sommer G N. Fibrosarcoma of the soft parts with special reference to recurrence and metastasis. Arch Surg. 1936; 33 425-450
- 3 Cahan W G, Woodward H Q, Higinbotham N L. Sarcoma arising in irradiated bone: Report of eleven cases. Cancer. 1948; I 3-29
- 4 Maddox J C, Evans H L. Angiosarcoma of skin and soft tissue: a study of forty-four cases. Cancer. 1981; 48 1907-1921
- 5 Rao J, DeKoven J G, Beatty J D, Jones J. Cutaneous angiosarcoma as a delayed complication of radiation therapy for carcinoma of the breast. J Am Acad Dermatol. 2003; 49 532-538
- 6 Monroe A T, Feigenberg S J, Mendenhall N P. Angiosarcoma after breast-conserving therapy. Cancer. 2003; 97 1832-1840
- 7 Catena F, Santini D, Di Saverio S, Laneve A, Ansaloni L, Fogacci T, Gagliardi S, Gazzotti F, Guidi G, De Cataldis A, Taffurelli M. Skin angiosarcoma arising in an irradiated breast: Case-report and literature review. Dermatol Surg. 2006; 32 447-455
- 8 Brenn T, Fletcher C DM. Radiation-associated cutaneous atypical vascular lesions and angiosarcomas. Am J Surg Pathol. 2005; 29 8
- 9 Hanasono M M, Osborne M P, Dielubanza E J, Peters S B, Gayle L B. Radiation-induced angiosarcoma after mastectomy and TRAM flap breast reconstruction. Ann Plastic Surg. 2005; 54 211-214
- 10 Mermershtain W, Cohen A D, Koretz M. et al . Cutaneous angiosarcoma of breast after lumpectomy, axillary lymph node dissection, and radiotherapy for primary breast carcinoma. Am J Clin Oncol. 2002; 25 597-598
- 11 Strobbe L JA, Peterse H L, van Tinteren H, Wijnmaalen A, Rutgers E JT. Angiosarcomas of the breast after conservation therapy for invasive cancer, the incidence and outcome. An unforeseen sequela. Breast Cancer Res Treatment. 1998; 47 101-109
- 12 Tomasini C, Grassi M, Pippione M. Cutaneous angiosarcoma arising in an irradiated breast. Dermatology. 2004; 209 208-214
- 13 Hauser N, Kreienberg R. Angiosarkom der Brust. Der Gynäkologe. 2005; 38 1113-1115
- 14 Majeski J R, Austin M, Fitzgerald R H. Cutaneous angiosarcoma in an irradiated breast after breast conservation therapy for cancer: Association with chronic breast lymphedema. J Surg Oncol. 2000; 74 208-213
- 15 Yap J, Chuba P J, Thomas R, Lucas D, Severson R K, Hamre M. Sarcoma as a second malignancy after treatment for breast cancer. Int J Radiat Oncol Biol Phys. 2002; 5 1231-1237
- 16 Fineberg S, Rosen P P. Cutaneous angiosarcoma and atypical vascular lesions of the skin and breast after radiation therapy for breast carcinoma. Am J Clin Pathol. 1994; 102 753-763
- 17 Tahir M, Hendry P, Baird L, Qureshi N A, Ritchie D, Whitford P. Radiation induced angiosarcoma a sequela of radiotherapy for breast cancer following conservative surgery. International Seminars in Surgical Oncology. 2006; 3 26
-
18 Little J B.
Cancer etiology: ionizing radiation. Holland J, Frei, E, Bast RC Cancer Medicine. 4th ed. Baltimore, MD; Williams & Wilkins 1997: 293-306 - 19 Givens S S, Ellerbrock N A. et al . Angiosarcoma arising in an irradiated breast. A case review of the literature. Cancer. 1989; 64 2214-2216
Dr. med. Rüdiger Koll
Tangstedter Landstraße 77
22415 Hamburg
Email: Ruediger.Koll@t-online.de