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The role of imaging in the diagnosis of primary and secondary breast angiosarcoma: 25-year experience of a provincial cancer institution

Published:November 16, 2022DOI:https://doi.org/10.1016/j.clbc.2022.11.003

      STRUCTURED ABSTRACT

      Background

      Breast angiosarcoma may arise spontaneously (primary breast angiosarcoma (PBA)) or may arise secondary to a biological insult, such as radiation therapy (secondary breast angiosarcoma (SBA)). We evaluated the imaging findings of patients diagnosed with PBA and SBA within the province of British Columbia, Canada.

      Methods

      This was a multi-center, retrospective study of patients diagnosed with PBA and SBA over a 25-year period. Patients were identified via a provincial database which registers all cases of sarcoma. Patients diagnosed with histologically proven PBA and SBA were eligible for inclusion. Multimodal breast imaging reviewed included mammography, ultrasound, magnetic resonance imaging, and computed tomography.

      Results

      Thirteen patients were diagnosed with PBA and 22 patients were diagnosed with SBA. The median (interquartile range (IQR)) age of patients diagnosed with PBA (45.5 years (19.7 years)) was less than that of patients diagnosed with SBA (75.8 years (13.8 years), p<0.001). Patients diagnosed with PBA (90.9%) were more likely to present with a parenchymal mass clinically and radiographically than those with SBA (28.6%, p<0.002). Patients diagnosed with SBA (71.4%) were more likely to present with cutaneous findings than patients diagnosed with PBA (0.0%, p<0.05). Without specific clinical context, the imaging findings of PBA and SBA were observed to be non-specific.

      Conclusion

      This is the only study which evaluated the imaging findings of patients diagnosed with PBA and SBA within a large, defined geographical area. Given non-specific imaging findings, awareness of the disease and clear and timely communication between radiologists and clinicians is required to ensure appropriate diagnosis and management.

      MICROABSTRACT

      We evaluated the imaging findings of patients diagnosed with primary breast angiosarcoma (PBA) and secondary breast angiosarcoma (SBA) within the province of British Columbia, Canada during a 25-year period in a multi-center, retrospective study. Without specific clinical context, the imaging findings of PBA and SBA were observed to be non-specific. Given non-specific imaging findings, awareness of the disease and clear and timely communication between radiologists and clinicians is required to ensure appropriate diagnosis and management.
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