Axillary Lymph Node Dissection in Angiosarcomas of the Breast: An Asian Institutional Perspective
Sharanniyan Ragavan,
Hui Jun Lim,
Joey Wee-Shan Tan,
Josephine Hendrikson,
Jason Yongsheng Chan,
Mohamad Farid,
Claramae Shulyn Chia,
Grace Hwei Ching Tan,
Khee Chee Soo,
Melissa Ching Ching Teo,
Chin-Ann Johnny Ong
Affiliations
Sharanniyan Ragavan
Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 169610, Singapore
Hui Jun Lim
Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 169610, Singapore
Joey Wee-Shan Tan
Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 169610, Singapore
Josephine Hendrikson
Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 169610, Singapore
Jason Yongsheng Chan
Division of Medical Oncology, National Cancer Centre Singapore, 169610, Singapore
Mohamad Farid
Division of Medical Oncology, National Cancer Centre Singapore, 169610, Singapore
Claramae Shulyn Chia
Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 169610, Singapore
Grace Hwei Ching Tan
Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 169610, Singapore
Khee Chee Soo
Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 169610, Singapore
Melissa Ching Ching Teo
Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 169610, Singapore
Chin-Ann Johnny Ong
Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 169610, Singapore
Angiosarcomas of the breast (ASB) are rare, making up to less than 8% of all angiosarcomas. The surgical management for this disease continues to vary throughout centres worldwide due to the current limited evidence. We aim to examine the necessity of axillary lymph node dissection in this pathology through a retrospective study of axillary metastasis and recurrence patterns in patients treated at our institution. A retrospective review of a prospectively-maintained database was performed. All adult patients with a histologically confirmed diagnosis of ASB seen at the National Cancer Centre Singapore between 2006 and 2019 were identified. Axillary lymph node status, treatment, survival, and recurrence data were collated. Thirteen patients were identified with a confirmed diagnosis of ASB, of which there were 11 primary and 2 secondary angiosarcoma cases. Eight patients had some form of axillary lymph node dissection and 5 did not. No positive nodes were found in any examined axillary nodes despite high median number of nodes harvested (13, range 8–24). 5/13 patients had disease progression, of whom none had locoregional recurrence to the axilla. ASB continues to be rare and recurrent and presents as a challenge to treat. Axillary lymph node involvement is most likely not present in a majority of patients. Prophylactic removal is unwarranted in patients presenting without lymph node involvement due to the lack of axillary metastasis.