Post-radiotherapy vascular lesions of the breast: immunohistochemical and molecular features of 74 cases with long-term follow-up and literature review

A.G. Corradini, S. Asioli, L. Morandi, M. Brotto, A. Righi, M. Iommi, C. Agostinelli, P. Rucci, A. Sapino, G. Viale, M.P. Foschini

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: A wide range of post-radiotherapy (RT) vascular lesions can occur, ranging from benign lymphangiomatous papules of the skin (BLAPs), to atypical vascular lesions (AVLs) and post-RT angiosarcomas (ASs). The relationship between benign and malignant post-RT breast lesions and their prognostic features are still controversial. The aims of this study were to investigate the relationship between benign and malignant mammary post-RT vascular lesions and to define post-RT AS prognostic features. Methods and results: Seventy-four post-RT vascular lesion cases were obtained and stained with antibodies against CD34, CD31, D2-40, Ki67, and c-Myc. Mutational analysis was performed by deep sequencing for the following genes: KRAS, NRAS, HRAS, BRAF, PIK3CA, TP53, NOTCH1, PTEN, CDKN2A, EGFR, AKT1, CTNNB1, hTERT, and PTPRB. Post-RT AS cases were graded according to a previously reported breast AS grading system. AVL cases showed a low number of HRAS and hTERT mutations, whereas post-RT AS cases showed a high frequency of EGFR, TP53, HRAS and hTERT mutations. On follow-up, all BLAP and AVL patients were alive with no evidence of disease. Post-RT AS 5-year overall survival declined with the increase in grade, as follows: 85.7% for grade 1, 83.3% for grade 2, and 40.4% for grade 3. Conclusions: Our findings confirm that BLAP and AVL have a good prognosis, and that post-RT AS prognosis is strongly related to histological grading. On molecular analysis, AVL and post-RT AS shared HRAS and hTERT mutations, suggesting a relationship between the two lesions. © 2020 John Wiley & Sons Ltd
Original languageEnglish
Pages (from-to)293-302
Number of pages10
JournalHistopathology
Volume77
Issue number2
DOIs
Publication statusPublished - 2020

Keywords

  • atypical vascular lesions
  • breast
  • genes
  • haemangiosarcoma
  • neoplasms
  • B Raf kinase
  • CD34 antibody
  • cyclin dependent kinase inhibitor 2A
  • Ki 67 antigen
  • monoclonal antibody D2-40
  • Myc protein
  • Notch1 receptor
  • phosphatidylinositol 3,4,5 trisphosphate 3 phosphatase
  • platelet endothelial cell adhesion molecule 1
  • protein kinase B
  • protein p53
  • telomerase reverse transcriptase
  • vasculotropin
  • adult
  • aged
  • angiosarcoma
  • Article
  • breast lesion
  • cancer grading
  • cancer radiotherapy
  • clinical feature
  • ctnnb 1 gene
  • follow up
  • gene mutation
  • human
  • immunohistochemistry
  • major clinical study
  • mutational analysis
  • oncogene
  • oncogene H ras
  • oncogene K ras
  • oncogene N ras
  • overall survival
  • pik3ca gene
  • priority journal
  • prognostic assessment
  • ptprb gene
  • sequence analysis
  • vascular lesion

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