Angiosarcoma in previously irradiated breast in patient with Li-Fraumeni syndrome

a case report

Authors

  • Oséias Vargas Barbosa Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS)
  • André Borba Reiriz Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS)
  • Ricardo Antônio Boff Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS)
  • Willian Passos Oliveira Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS)
  • Luiza Rossi Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS)

Keywords:

Radiotherapy, Hemangiosarcoma, Li-Fraumeni syndrome, Breast neoplasms, Genes, p53

Abstract

CONTEXT: Li-Fraumeni syndrome is a rare disease with an autosomal dominant inheritance pattern and high penetrance that defines a 50% chance of developing cancer before the age of 30 years, including cases of breast sarcoma. Patients with this syndrome who require radiotherapy have an increased risk of developing secondary malignancies including angiosarcomas. CASE REPORT: This was a case report on a female patient with Li-Fraumeni syndrome. In October 2005, she was diagnosed with invasive ductal carcinoma of the right breast and underwent sectorectomy. She then received chemotherapy and adjuvant radiotherapy. Trastuzumab and tamoxifen were also part of the treatment. She recently sought care at our hospital, complaining of hyperemia and nodulation in the right breast, and underwent surgical resection that revealed epithelioid angiosarcoma. CONCLUSIONS: When genetic predisposition due to Li-Fraumeni syndrome is documented, the therapy should be adapted so as to minimize the risk. Thus, conservative surgical treatments should be avoided and mastectomy without radiation should be prioritized. In cases in which use of radiotherapy is justified, patients should be followed up intensively.

Downloads

Download data is not yet available.

Author Biographies

Oséias Vargas Barbosa, Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS)

Medical Student. Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS), Caxias do Sul, Rio Grande do Sul, Brazil.

André Borba Reiriz, Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS)

MD, PhD. Titular Professor and Head, Department of Oncology, Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS), Caxias do Sul, Rio Grande do Sul, Brazil

Ricardo Antônio Boff, Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS)

MD. Mastologist, Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS), Caxias do Sul, Rio Grande do Sul, Brazil.

Willian Passos Oliveira, Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS)

Medical Student. Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS), Caxias do Sul, Rio Grande do Sul, Brazil.

Luiza Rossi, Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS)

Medical Student. Faculdade de Medicina da Universidade de Caxias do Sul (FMUCS), Caxias do Sul, Rio Grande do Sul, Brazil

References

Galper S, Gelman R, Recht A, et al. Second nonbreast malignancies after conservative surgery and radiation therapy for early-stage breast cancer. Int J Radiat Oncol Biol Phys. 2002;52(2):406-14.

Gonzalez KD, Noltner KA, Buzin CH, et al. Beyond Li Fraumeni Syndrome: clinical characteristics of families with p53 germline mutations. J Clin Oncol. 2009;27(8):1250-6.

Malkin D. Li-fraumeni syndrome. Genes Cancer. 2011;2(4):475-84.

Malkin D. p53 and the Li-Fraumeni syndrome. Biochim Biophys Acta. 1994;1198(2-3):197-213.

Kirova YM, Gambotti L, De Rycke YD, et al. Risk of second malignancies after adjuvant radiotherapy for breast cancer: a large-scale, single-institution review. Int J Radiat Oncol Biol Phys. 2007;68(2):359-63.

Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Darby S, McGale P, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378(9804):1707-16.

Turnbull C, Mirugaesu N, Eeles R. Radiotherapy and genetic predisposition to breast cancer. Clin Oncol (R Coll Radiol). 2006;18(3):257-67.

Riad S, Biau D, Holt GE, et al. The clinical and functional outcome for patients with radiation-induced soft tissue sarcoma. Cancer. 2012;118(10):2682-92.

Young RJ, Brown NJ, Reed MW, Hughes D, Woll PJ. Angiosarcoma. Lancet Oncol. 2010;11(10):983-91.

Marchal C, Weber B, de Lafontan B, et al. Nine breast angiosarcomas after conservative treatment for breast carcinoma: a survey from French comprehensive Cancer Centers. Int J Radiat Oncol Biol Phys. 1999;44(1):113-9.

Pendlebury SC, Bilous M, Langlands AO. Sarcomas following radiation therapy for breast cancer: a report of three cases and a review of the literature. Int J Radiat Oncol Biol Phys. 1995; 31(2):405-10.

Yap J, Chuba PJ, Thomas R, et al. Sarcoma as a second malignancy after treatment for breast cancer. Int J Radiat Oncol Biol Phys. 2002;52(5):1231-7.

Downloads

Published

2015-03-03

How to Cite

1.
Barbosa OV, Reiriz AB, Boff RA, Oliveira WP, Rossi L. Angiosarcoma in previously irradiated breast in patient with Li-Fraumeni syndrome: a case report. Sao Paulo Med J [Internet]. 2015 Mar. 3 [cited 2025 Oct. 15];133(2):151-3. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1039

Issue

Section

Case Report