Skip to main content
British Journal of Cancer logoLink to British Journal of Cancer
. 1999 Oct;81(3):532–536. doi: 10.1038/sj.bjc.6690726

The risk of angiosarcoma following primary breast cancer

W Cozen 1, L Bernstein 1, F Wang 1, M F Press 2, T M Mack 1
PMCID: PMC2362921  PMID: 10507781

Abstract

Lymphangiosarcoma of the upper extremity is a rare and aggressive tumour reported to occur following post-mastectomy lymphoedema (Stewart–Treves syndrome). Haemangiosarcoma, a related rare tumour, has occasionally been reported to occur in the breast following irradiation. We conducted a case-control study using the University of Southern California-Cancer Surveillance Program, the population-based cancer registry for Los Angeles County, to evaluate the relationship between invasive female breast cancer and subsequent upper extremity or chest lymphangiosarcoma and haemangiosarcoma together referred to as angiosarcoma. Cases were females diagnosed between 1972 and 1995 with angiosarcoma of the upper extremity (n = 20) or chest (n = 48) who were 25 years of age or older and residing in Los Angeles County when diagnosed. Other sarcomas at the same anatomic sites were also studied. Controls were females diagnosed with cancers other than sarcoma during the same time period (n = 266 444). Cases and controls were then compared with respect to history of a prior invasive epithelial breast cancer. A history of breast cancer increased the risk of upper extremity angiosarcoma by more than 59-fold (odds ratio [OR] = 59.3, 95% confidence interval [95% CI] = 21.9–152.8). A strong increase in risk after breast cancer was also observed for angiosarcoma of the chest and breast (OR = 11.6, 95% CI = 4.3–26.1) and for other sarcomas of the chest and breast (OR = 3.3, 95% CI = 1.1–1.7). © 1999 Cancer Research Campaign

Keywords: breast cancer, Stewart–Treves syndrome, lymphangiosarcoma, haemangiosarcoma, angiosarcoma, radiation, lymphoedema

Full Text

The Full Text of this article is available as a PDF (60.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Appelqvist P., Salmo M., Rissanen P., Wiklund T. Response of postmastectomy lymphangiosarcoma to radiotherapy: report of four cases. Strahlenther Onkol. 1990 Mar;166(3):194–198. [PubMed] [Google Scholar]
  2. Ewertz M., Mouridsen H. T. Second cancer following cancer of the female breast in Denmark, 1943-80. Natl Cancer Inst Monogr. 1985 Dec;68:325–329. [PubMed] [Google Scholar]
  3. Ferguson D. J., Sutton H. G., Jr, Dawson P. J. Late effects of adjuvant radiotherapy for breast cancer. Cancer. 1984 Dec 1;54(11):2319–2323. doi: 10.1002/1097-0142(19841201)54:11<2319::aid-cncr2820541102>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  4. Harvey E. B., Brinton L. A. Second cancer following cancer of the breast in Connecticut, 1935-82. Natl Cancer Inst Monogr. 1985 Dec;68:99–112. [PubMed] [Google Scholar]
  5. Janse A. J., van Coevorden F., Peterse H., Keus R. B., van Dongen J. A. Lymphedema-induced lymphangiosarcoma. Eur J Surg Oncol. 1995 Apr;21(2):155–158. doi: 10.1016/s0748-7983(95)90270-8. [DOI] [PubMed] [Google Scholar]
  6. Karpeh M. S., Jr, Caldwell C., Gaynor J. J., Hajdu S. I., Brennan M. F. Vascular soft-tissue sarcomas. An analysis of tumor-related mortality. Arch Surg. 1991 Dec;126(12):1474–1481. doi: 10.1001/archsurg.1991.01410360044008. [DOI] [PubMed] [Google Scholar]
  7. Kim J. H., Chu F. C., Woodard H. Q., Melamed M. R., Huvos A., Cantin J. Radiation-induced soft-tissue and bone sarcoma. Radiology. 1978 Nov;129(2):501–508. doi: 10.1148/129.2.501. [DOI] [PubMed] [Google Scholar]
  8. Kuten A., Sapir D., Cohen Y., Haim N., Borovik R., Robinson E. Postirradiation soft tissue sarcoma occurring in breast cancer patients: report of seven cases and results of combination chemotherapy. J Surg Oncol. 1985 Mar;28(3):168–171. doi: 10.1002/jso.2930280304. [DOI] [PubMed] [Google Scholar]
  9. Mack T. M. Cancer surveillance program in Los Angeles County. Natl Cancer Inst Monogr. 1977 Dec;47:99–101. [PubMed] [Google Scholar]
  10. Mack T. M. Sarcomas and other malignancies of soft tissue, retroperitoneum, peritoneum, pleura, heart, mediastinum, and spleen. Cancer. 1995 Jan 1;75(1 Suppl):211–244. doi: 10.1002/1097-0142(19950101)75:1+<211::aid-cncr2820751309>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  11. Maddox J. C., Evans H. L. Angiosarcoma of skin and soft tissue: a study of forty-four cases. Cancer. 1981 Oct 15;48(8):1907–1921. doi: 10.1002/1097-0142(19811015)48:8<1907::aid-cncr2820480832>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  12. Malkin D., Li F. P., Strong L. C., Fraumeni J. F., Jr, Nelson C. E., Kim D. H., Kassel J., Gryka M. A., Bischoff F. Z., Tainsky M. A. Germ line p53 mutations in a familial syndrome of breast cancer, sarcomas, and other neoplasms. Science. 1990 Nov 30;250(4985):1233–1238. doi: 10.1126/science.1978757. [DOI] [PubMed] [Google Scholar]
  13. Mark R. J., Poen J., Tran L. M., Fu Y. S., Selch M. T., Parker R. G. Postirradiation sarcomas. A single-institution study and review of the literature. Cancer. 1994 May 15;73(10):2653–2662. doi: 10.1002/1097-0142(19940515)73:10<2653::aid-cncr2820731030>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  14. McCLANAHAN B. J., HOGG L., Jr Angiosarcoma of the breast. Cancer. 1954 May;7(3):586–594. doi: 10.1002/1097-0142(195405)7:3<586::aid-cncr2820070317>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
  15. Rubin E., Maddox W. A., Mazur M. T. Cutaneous angiosarcoma of the breast 7 years after lumpectomy and radiation therapy. Radiology. 1990 Jan;174(1):258–260. doi: 10.1148/radiology.174.1.2152984. [DOI] [PubMed] [Google Scholar]
  16. Schottenfeld D., Berg J. Incidence of miltiple primary cancers. IV. Cancers of the female breast and genital organs. J Natl Cancer Inst. 1971 Jan;46(1):161–170. [PubMed] [Google Scholar]
  17. Senyszyn J. J., Johnston A. D., Jacox H. W., Chu F. C. Radiation-induced sarcoma after treatment of breast cancer. Cancer. 1970 Aug;26(2):394–403. doi: 10.1002/1097-0142(197008)26:2<394::aid-cncr2820260221>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  18. Somasundaram K., Zhang H., Zeng Y. X., Houvras Y., Peng Y., Zhang H., Wu G. S., Licht J. D., Weber B. L., El-Deiry W. S. Arrest of the cell cycle by the tumour-suppressor BRCA1 requires the CDK-inhibitor p21WAF1/CiP1. Nature. 1997 Sep 11;389(6647):187–190. doi: 10.1038/38291. [DOI] [PubMed] [Google Scholar]
  19. Souba W. W., McKenna R. J., Jr, Meis J., Benjamin R., Raymond A. K., Mountain C. F. Radiation-induced sarcomas of the chest wall. Cancer. 1986 Feb 1;57(3):610–615. doi: 10.1002/1097-0142(19860201)57:3<610::aid-cncr2820570336>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  20. Sánchez R. B., Quinn S. F., Walling A., Estrada J., White V. Case report 569: Lymphangiosarcoma of the right upper extremity. Skeletal Radiol. 1989;18(6):485–487. doi: 10.1007/BF00368623. [DOI] [PubMed] [Google Scholar]
  21. Taghian A., de Vathaire F., Terrier P., Le M., Auquier A., Mouriesse H., Grimaud E., Sarrazin D., Tubiana M. Long-term risk of sarcoma following radiation treatment for breast cancer. Int J Radiat Oncol Biol Phys. 1991 Jul;21(2):361–367. doi: 10.1016/0360-3016(91)90783-z. [DOI] [PubMed] [Google Scholar]
  22. Wiklund T. A., Blomqvist C. P., Räty J., Elomaa I., Rissanen P., Miettinen M. Postirradiation sarcoma. Analysis of a nationwide cancer registry material. Cancer. 1991 Aug 1;68(3):524–531. doi: 10.1002/1097-0142(19910801)68:3<524::aid-cncr2820680313>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  23. Woodward A. H., Ivins J. C., Soule E. H. Lymphangiosarcoma arising in chronic lymphedematous extremities. Cancer. 1972 Aug;30(2):562–572. doi: 10.1002/1097-0142(197208)30:2<562::aid-cncr2820300237>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  24. d'Amore E. S., Wick M. R., Geisinger K. R., Frizzera G. Primary malignant lymphoma arising in postmastectomy lymphedema. Another facet of the Stewart-Treves syndrome. Am J Surg Pathol. 1990 May;14(5):456–463. doi: 10.1097/00000478-199005000-00005. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES