The risk of angiosarcoma following primary breast cancer

Lymphangiosarcoma of the upper extremity is a rare and aggressive tumour re ported to occur following post-mastectomy lymphoedema (Stewart-Treves syndr ome). Haemangiosarcoma, a related rare tumour, has occasionally been report ed to occur in the breast following irradiation. We conducted a case-contro l study using the University of Southern California-Cancer Surveillance Pro gram, the population-based cancer registry for Los Angeles County to evalua te the relationship between invasive female breast cancer and subsequent up per extremity or chest lymphangiosarcoma and haemangiosarcoma together refe rred to as angiosarcoma. Cases were females diagnosed between 1972 and 1995 with angiosarcoma of the upper extremity (n = 20) or chest (n = 48) who we re 25 years of age or older and residing in Los Angeles County when diagnos ed. Other sarcomas at the same anatomic sites were also studied. Controls w ere females diagnosed with cancers other than sarcoma during the same time period (n = 266 444). Cases and controls were then compared with respect to history of a prior invasive epithelial breast cancer. A history of breast cancer increased the risk of upper extremity angiosarcoma by more than 59-f old (odds ratio [OR] = 59.3, 95% confidence interval [95% CI] = 21.9-152.8) . A strong increase in risk after breast cancer was also observed for angio sarcoma of the chest and breast (OR = 11.6, 95% CI = 4.3-26.1) and for othe r sarcomas of the chest and breast (OR = 3.3, 95% Gi = 1.1-1.7). (C) 1999 C ancer Research Campaign.