Management of Localized Breast Angiosarcoma by North American Radiation and Medical Oncologists.

Abstract

INTRODUCTION:

Primary breast angiosarcoma is a rare malignancy with no clinical trials to guide management. The current use of surgery, chemotherapy, and radiotherapy among North American oncologists is unknown.

PATIENTS AND METHODS:

An institutional review board-approved anonymous electronic survey was distributed to 9660 practicing North American radiation and medical oncologists. Questions pertained to treatment recommendations for localized nonmetastatic primary breast angiosarcoma, as well as knowledge/use of β-blockers in angiosarcoma. The Fisher exact test was used to compare responses of medical and radiation oncologists.

RESULTS:

Surgery was recommended by 95% of all respondents. Chemotherapy was recommended by over half of medical and radiation oncologists. Radiotherapy was recommended by 92% of radiation and 56% of medical oncologists. The most common treatment recommendation was a trimodal treatment, with up-front surgery followed by adjuvant chemotherapy, then by adjuvant radiotherapy. Twenty-two percent of respondents were aware of clinical data pertaining to the use of β-blockers in management of angiosarcoma, and among these respondents 69% were comfortable incorporating this treatment into standard practice.

CONCLUSION:

Trimodal management of primary localized breast angiosarcoma is supported by North American radiation and medical oncologists, with the majority recommending up-front surgery followed by adjuvant chemotherapy and radiation. The recently published reports of successful use of β-blockers are not yet known among North American clinicians, but there is a great enthusiasm to incorporate these commonly prescribed medications into standard practice. These findings may greatly influence the standard of care for breast angiosarcoma treatment, particularly given the absence of Level I-supported evidence.

• Authors: Jess Hatfield, Shearwood McClelland 3rd, Jia Luo, Catherine Degnin, Yiyi Chen, Ronald J Maggiore, Timur Mitin
• Journal: Clinical breast cancer (Clin Breast Cancer) Vol. 18 Issue 6 Pg. 498-503 (12 2018) ISSN: 1938-0666 [Electronic] United States
• PMID: 30482726 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Topics

• Breast Neoplasms (pathology, therapy)
• Combined Modality Therapy
• Disease Management
• Female
• Hemangiosarcoma (pathology, therapy)
• Humans
• Oncologists (statistics & numerical data)
• Practice Patterns, Physicians' (trends)
• Prognosis
• Radiation Oncologists (statistics & numerical data)
• Surveys and Questionnaires