@article{7929f1cf10864ab19fa9c2d4bda83022,
title = "Post-radiotherapy vascular lesions of the breast: immunohistochemical and molecular features of 74 cases with long-term follow-up and literature 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. {\textcopyright} 2020 John Wiley & Sons Ltd",
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",
author = "A.G. Corradini and S. Asioli and L. Morandi and M. Brotto and A. Righi and M. Iommi and C. Agostinelli and P. Rucci and A. Sapino and G. Viale and M.P. Foschini",
note = "Cited By :1 Export Date: 2 March 2021 CODEN: HISTD Correspondence Address: Corradini, A.G.; Department of Biomedical and Neuromotor Sciences, Italy; email: angelo.corradini@studio.unibo.it Chemicals/CAS: phosphatidylinositol 3,4,5 trisphosphate 3 phosphatase, 210488-47-4; protein kinase B, 148640-14-6; telomerase reverse transcriptase, 120178-12-3; vasculotropin, 127464-60-2 Funding details: Universit{\`a} di Bologna, UNIBO Funding text 1: This work was supported by Fundamentally Oriented Research (RFO) 2015, University of Bologna, Italy to So.A. References: Tavassoli, A., Eusebi, V., Sarcomas (2009) Tumors of the mammary gland, pp. 310-311. , Silverberg SG, eds., AFIP atlas of tumor pathology, series 4., Washington DC, American Registry of Pathology in collaboration with Armed Forces Institute of Pathology; Fraga-Guedes, C., Andr{\'e}, S., Mastropasqua, M.G., Angiosarcoma and atypical vascular lesions of the breast: diagnostic and prognostic role of MYC gene amplification and protein expression (2015) Breast Cancer Res. Treat., 151, pp. 131-140; Patton, K.T., Deyrup, A.T., Weiss, S.W., Atypical vascular lesions after surgery and radiation of the breast: a clinicopathologic study of 32 cases analyzing histologic heterogeneity and association with angiosarcoma (2008) Am. J. Surg. Pathol., 32, pp. 943-950; Fineberg, S., Rosen, P.P., Cutaneous angiosarcoma and atypical vascular lesions of the skin and breast after radiation therapy for breast carcinoma (1994) Am. J. Clin. Pathol., 102, pp. 757-763; Brenn, T., Fletcher, C.D., Radiation-associated cutaneous atypical vascular lesions and angiosarcoma: clinicopathologic analysis of 42 cases (2005) Am. J. Surg. Pathol., 29, pp. 983-996; Ginter, P.S., Mosquera, J.M., MacDonald, T.Y., D{\textquoteright}Alfonso, T.M., Rubin, M.A., Shin, S.J., Diagnostic utility of MYC amplification and anti-MYC immunohistochemistry in atypical vascular lesions, primary or radiation-induced mammary angiosarcomas, and primary angiosarcomas of other sites (2014) Hum. Pathol., 45, pp. 709-716; Ginter, P.S., McIntire, P.J., Shin, S.J., Vascular tumours of the breast: a comprehensive review with focus on diagnostic challenges encountered in the core biopsy setting (2017) Pathology, 49, pp. 197-214; Strobbe, L.J.A., Peterse, H.L., van Tinteren, H., Wijnmaalen, A., Rutgers, E.J., Angiosarcoma of the breast after conservation therapy for invasive cancer, the incidence and outcome: an unforeseen sequela (1998) Breast Cancer Res. Treat., 47, pp. 101-109; Bov{\'e}e, J.V.M.G., Rosenberg, A.E., Vascular tumors (2013) World Health Organization classification of tumors of soft tissue and bone, pp. 156-158. , Fletcher CDM, Bridge J, Hogendoorn P, Mertens F, eds,, 4th edn, Lyon, International Agency for Research on Cancer (IARC); Donnell, R.M., Rosen, P.P., Lieberman, P.H., Angiosarcoma and other vascular tumors of the breast (1981) Am. J. Surg. Pathol., 5, pp. 629-642; Rosen, P.P., Kimmel, M., Mammary angiosarcoma. The prognostic significance of tumor differentiation (1988) Cancer, 62, pp. 2145-2151; Nascimento, A.F., Raut, C.P., Fletcher, C.D., Primary angiosarcoma of the breast: clinicopathologic analysis of 49 cases, suggesting that grade is not prognostic (2008) Am. J. Surg. Pathol., 32, pp. 1896-1904; Hung, J., Hiniker, S.M., Sporadic versus radiation-associated angiosarcoma: a comparative clinicopathologic and molecular analysis of 48 cases (2013) Sarcoma, 2013, p. 798403; Murali, R., Chandramohan, R., Targeted massively parallel sequencing of angiosarcomas reveals frequent activation of the mitogen activated protein kinase pathway (2015) Oncotarget, 6, pp. 36041-36052; Depla, A.L., Scharloo-Karels, C.H., Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer: a systematic review (2014) Eur. J. Cancer, 50, pp. 1779-1788; Morandi, L., Righi, A., Maletta, F., Somatic mutation profiling of hobnail variant of papillary thyroid carcinoma (2017) Endocr. Relat. Cancer, 24, pp. 107-117; Gabusi, A., Gissi, D.B., Tarsitano, A., Intratumoral heterogeneity in recurrent metastatic squamous cell carcinoma of the oral cavity: new perspectives afforded by multiregion DNA sequencing and mtDNA analysis (2019) J. Oral Maxillofac. Surg., 77, pp. 440-455; Adzhubei, I.A., Schmidt, S., Peshkin, L., A method and server for predicting damaging missense mutations (2010) Nat. Methods, 7, pp. 248-249",
year = "2020",
doi = "10.1111/his.14090",
language = "English",
volume = "77",
pages = "293--302",
journal = "Histopathology",
issn = "0309-0167",
publisher = "Blackwell Publishing Ltd",
number = "2",
}