@article{a8fdf971635c47e98caf1c56b2b96ac1,
title = "Changing clinical presentation of angiosarcomas after breast cancer: from late tumors in edematous arms to earlier tumors on the thoracic wall",
abstract = "Angiosarcoma is a rare complication of breast cancer treatment. In order to define predictors, clinical presentation, and outcome, we characterized a population-based 50-year cohort of angiosarcomas after breast cancer. Clinical data were collected from all females with previous breast cancer who developed angiosarcomas/lymphangiosarcomas on the thoracic wall/upper extremity between 1958 and 2008 in the Southern Swedish health care region. In total, 31 angiosarcomas developed at a median age of 71 years. The patients formed two distinct groups; 14 females treated for breast cancer with radical mastectomy and radiotherapy 1949-1988 developed angiosarcomas in edematous arms (Stewart-Treves syndrome) after median 11 years, and 17 females treated by segmental resection, anti-hormonal treatment and radiotherapy 1980-2005 developed angiosarcomas in the irradiated field on the thoracic wall after median 7.3 years. The clinical presentations were heterogeneous and included hematoma-like lesions, multiple bluish-reddish nodules, and asymptomatic lumps. The overall 5-year survival was 16%. In this population-based cohort, the early angiosarcomas developed in edematous arms after radical mastectomies, whereas more recent cases occurred after a shorter time period in the irradiated fields following breast conserving surgery. We conclude that the clinical presentation of angiosarcomas has changed, parallel with altered treatment principles for breast cancer.",
keywords = "Adult, Aged, Aged, 80 and over, Arm, Breast Neoplasms, Cohort Studies, Edema, Female, Hemangiosarcoma, Humans, Middle Aged, Neoplasm Recurrence, Local, Neoplasms, Second Primary, Prognosis, Thoracic Wall",
author = "Emelie Styring and Josefin Fernebro and Per-Ebbe J{\"o}nsson and Anna Ehinger and Jacob Engellau and Pehr Rissler and Anders Rydholm and Mef Nilbert and {Vult von Steyern}, Fredrik",
year = "2010",
doi = "10.1007/s10549-009-0703-8",
language = "English",
volume = "122",
pages = "883--7",
journal = "Breast Cancer Research and Treatment",
issn = "1573-7217",
publisher = "Springer",
number = "3",
}