Radiation-induced sarcoma of the breast: A systematic review

Grishma R. Sheth, Lee D Cranmer, Benjamin D. Smith, Lauren Grasso-LeBeau, Julie E. Lang

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48 Scopus citations

Abstract

Introduction. Radiation-induced sarcoma (RIS) is a rare, aggressive malignancy. Breast cancer survivors treated with radiotherapy constitute a large fraction of RIS patients. To evaluate evidenced-based practices for RIS treatment, we performed a systematic review of the published English-language literature. Methods. We performed a systematic keyword search of PubMed for original research articles pertaining to RIS of the breast. We classified and evaluated the articles based on hierarchal levels of scientific evidence. Results. We identified 124 original articles available for analysis, which included 1,831 patients. No randomized controlled trials involving RIS patients were found. We present the best available evidence for the etiology, comparative biology to primary sarcoma, prognostic factors, and treatment options for RIS of the breast. Conclusion. Although the evidence to guide clinical practice is limited to single institutional cohort studies, registry studies, case-control studies, and case reports, we applied the available evidence to address clinically relevant questions related to best practice in patient management. Surgery with widely negative margins remains the primary treatment of RIS. Unfortunately, the role of adjuvant and neoadjuvant chemotherapy remains uncertain. This systematic review highlights the need for additional well-designed studies to inform the management of RIS.

Original languageEnglish (US)
Pages (from-to)405-418
Number of pages14
JournalOncologist
Volume17
Issue number3
DOIs
Publication statusPublished - 2012

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Keywords

  • Angiosarcoma
  • Breast cancer
  • Radiation-induced
  • Radiotherapy
  • Sarcoma
  • Second primary malignancy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Sheth, G. R., Cranmer, L. D., Smith, B. D., Grasso-LeBeau, L., & Lang, J. E. (2012). Radiation-induced sarcoma of the breast: A systematic review. Oncologist, 17(3), 405-418. https://doi.org/10.1634/theoncologist.2011-0282