Radiation induced angiosarcoma of the breast

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lene
lene Member Posts: 4
edited June 2014 in Radiation Therapy - Before, During, and After

My 67 year old sister, living in Switzerland, was diagnosed in April 2002 with cancer in her right breast. The trumor was removed (lumpectomy) followed by chemo therapy, then radiation therapy. After that she was for 5 years on tamoxifen. She did very well, never missed an appointment (every 3 months) and was very watchful herself. She was almost 6 years cancer free. But in April 2008 she was diagnosed with radiation induced angiosarcoma of the same breast. We were told that this is avery rare and aggressive cancer. Subsequently her right breast was removed, as well as 16 lymph nodes from under her righrt arm. One of them was found to be cancerous. The surgery went well and she regained almost  full range of her. right arm. She is now ready for her new cancer treatment which is of all things radiation therapy again, the same treatment that got her into trouble. This is difficult for me to understand. I would like to communicate with persons who have experience with radiation induced angio-sarcoma of the breast. Any helpful information will be much appreciated.

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  • pinoideae
    pinoideae Member Posts: 1,271
    edited July 2008

    In Canada, as I understand it, you cannot be radiated twice.

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  • lene
    lene Member Posts: 4
    edited July 2008

    Summer,

    Thanks

    for the
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  • lene
    lene Member Posts: 4
    edited July 2008

    Summer,

    Thanks

    for the
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  • Shirlann
    Shirlann Member Posts: 3,302
    edited July 2008

    Oh for cripes sake, I sure would dig hard and long into everything you can find, this just doesn't seem right, but I have no specific information.  But SOMEBODY must!  If not, just keep reading JAMA, The New England Journal of Medicine, and Lancet.  They are medical journals and you can find your topic and ask just for it.

    This seems like something that needs at least a second opinion and maybe a third.

    Sheesh, does this nightmare ever end?

    Hugs, Shirlann 

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  • pinoideae
    pinoideae Member Posts: 1,271
    edited July 2008

    Hi lene, I guess I wasn't very helpful, but I found some new information for you, and a link to the website as follows:

    When radiation is NOT an option

    Radiation is not an option for you if:

    • You have already had radiation to that area of the body.
    • You have a connective tissue disease, such as scleroderma or vasculitis, which makes you extra-sensitive to the side effects of radiation.
    • You are pregnant and so should not have radiation therapy.
    • You are not willing to commit to the daily schedule of radiation therapy, or distance makes it impossible.

    Can radiation therapy be repeated to the same area again?

    Full-dose radiation is usually given only once to a particular part of the body. Your normal tissues can safely tolerate a limited amount of radiation. Your radiation oncologist knows how to pick the right dose of radiation to accomplish two things:

    • reach the maximum therapeutic dose-the amount that's likely to destroy cancer cells, and
    • avoid or minimize side effects to the normal tissue.

    After radiation is over, the normal tissues heal and get back to normal. But because you have received about as much radiation as your healthy cells can safely handle, it is not possible to treat this area again with another full dose of radiation. If cancer returns to the same breast area, depending on the radiation dose you already received, you may or may not be able to receive a limited amount of additional radiation treatment in that same area. Your doctor will know what the limits are, and together you can decide if this is a good treatment option for you.

    It's important to note that this information refers to treating the SAME part of the body a second time. If cancer should occur elsewhere in your body, outside the treated breast, radiation can be used to its full effect.

    http://www.breastcancer.org/treatment/radiation/when_appropriate.jsp

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  • snowyday
    snowyday Member Posts: 1,478
    edited July 2008
    I

    Radiation-induced angiosarcoma after mastectomy and TRAM flap breast reconstruction.

    Hanasono MM, Osborne MP, Dielubanza EJ, Peters SB, Gayle LB.

    Division of Plastic Surgery, Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY 10021, USA.

    Radiation-induced angiosarcoma of the breast is being reported with increasing frequency as a result of the increased use of radiation therapy in conjunction with breast conservation surgery. However, this entity has not been well documented in patients undergoing mastectomy. The authors present a case of angiosarcoma occurring in a patient 6 years after undergoing mastectomy for invasive duct carcinoma with immediate transverse rectus abdominis musculocutaneous flap reconstruction followed by postoperative radiation therapy. The diagnosis of angiosarcoma was made by skin biopsy performed by the patient's reconstructive surgeon on routine follow-up examination. This is the first reported case of postradiation angiosarcoma occurring in a postmastectomy breast reconstructed with autogenous tissue and it is unusual in that the cancer invaded the musculocutaneous flap. Diagnosis and management recommendations for radiation-induced angiosarcoma are discussed.

    PMID: 15655476 [PubMed - indexed for MEDLINE]

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    Privacy Statement | Freedom of Information Act found this on radiation induced angio-sarcoma.  Here goes!
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  • pinoideae
    pinoideae Member Posts: 1,271
    edited July 2008

    I see you got this information from Pub Med.  I find this a good website too.

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  • TenderIsOurMight
    TenderIsOurMight Member Posts: 4,493
    edited July 2008

    Angiosarcoma of the breast is indeed very aggressive, hence treatment is aggressive, often including the three backbones of traditional cancer treatment: surgical excision, radiation and chemotherapy.
     
    As your sister had one positive node (presuming involvement with the angiosarcoma cells), it appears her doctors wish to "sterilize" the nodal area(s) with radiation, which probably was not irradiated at the time of her lumpectomy and breast radiation.
     
    Given the aggressive cell nature of angiosarcoma, your sisters doctors may feel it necessary also to resterilize the chest wall so as to halt growth. While optimally this is avoided, at times it is felt the benefit outweighs the risk.
     
    I share this just from my reading and understanding of angiosarcoma of the breast, not from personal knowledge. I did have radiation myself in the past.
     
    I am sorry for your sister's trouble. Perhaps her doctors will discuss chemotherapy with her also, yet I do not know if it is used much in these circumstances.
     
    Positive thoughts being sent her and your way,
    Tender 
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  • pinoideae
    pinoideae Member Posts: 1,271
    edited July 2008

    I hope all is well with your sister lene, I know how devistated I would be if one of my sister's got bc once, let alone twice.  Hugs and prayers for your sister and family.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited July 2008

    Iene:  Im sorry to read about your sister.  I must admit, the information I have read here today to be so interesting and helpful.  Sending big hugs to you and your sister.

    Nicki

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  • Sandy_Sue
    Sandy_Sue Member Posts: 1
    edited April 2013

    Hi lene, I know it's been a while since you wrote your post about your sister but I'm in a similar situation so I'm curious what your sister chose for treatment. My mother is 67 and just had a mastectomy to remove her radiation induced angiosarcoma. Now the doctor is suggesting more radiation and chemo even though radiation was the cause of this. I also don't know why she would need chemo again since they said it did not spread into her blood or organs. I hate to see her endure more radiation if that will only cause more problems. Did you sister opt for more radiation?  Thank you for any insight or information you may have because as you know, we are only told this rare and they are not sure how to treat it, so that just makes this an even more sad and stressful time for us.  thank you again, I hope you are doing well. Sandy

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