P8. Primary Breast Angiosarcoma: Clinicopathologic Features and Oncologic Outcomes

Thursday, March 5, 2026

11:21 AM - 11:28 AM MST

Location: 301A

Co-Author(s)

AP

Alexander N. Perez, MD

Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center
Nashville, Tennessee, United States
EW

Emma Wingate, n/a

Tufts University
Boston, Massachusetts, United States
AS

Aparna Subramaniam, MBBS

Department of Sarcoma Medical Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
MY

Min Yi, MD, PhD

Biostatistician
Department of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Emily Z. Keung, MD (she/her/hers)

Assistant Professor of Surgical Oncology
Department of Surgical Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Christina L. Roland, MD

Professor of Surgical Oncology
Department of Surgical Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Keila E. Torres, MD, PhD, MBA

Professor
Department of Surgical Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Christopher P. Scally, MD

Assistant Professor
Department of Surgical Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Heather G. Lyu, MD

Assistant Professor
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center
Houston, Texas, United States
DM

Devarati Mitra, MD

Department of Radiation Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
AF

Ahsan S. Farooqi, MD, PhD

Department of Radiation Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
AB

Andrew J. Bishop, MD

Department of Radiation Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Ashleigh Guadagnolo, MD, MPH

Professor
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
AY

Alison K. Yoder, MD, MPH

Department of Radiation Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
AL

Alexander Lazar, MD, PhD

Professor, Department of Pathology
Department of Anatomical Pathology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Kelly K. Hunt, MD (she/her/hers)

Chair
Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center
Houston, Texas, United States
VR

Vinod Ravi, MD

Associate Professor
Department of Sarcoma Medical Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Heather A. Lillemoe, MD

Assistant Professor
Departments of Breast Surgical Oncology and Surgical Oncology (Sarcoma), University of Texas MD Anderson Cancer Center
Houston, Texas, United States

Primary Presenter(s)

Rick D. Vavolizza, MD

Fellow
Department of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center
Houston, Texas, United States

Slides

Introduction: Primary breast angiosarcoma is a rare, aggressive malignancy with low overall survival (OS). There is limited data related to outcomes for this disease as studies often combine patients with both primary and secondary angiosarcomas; however, these tumor types are distinct entities with different molecular signatures. This study aims to capture clinicopathologic features and treatment patterns for patients with primary breast angiosarcoma from a comprehensive cancer center to inform future management.

Methods: A retrospective study was conducted of patients with primary breast angiosarcoma who received care at a single tertiary care center from 1991 through 2025 and underwent surgical resection. Patients were excluded if they had insufficient data, short follow-up, or prior chest radiation. Clinicopathologic features and treatment patterns were analyzed using descriptive statistics, and survival data were analyzed using the Kaplan-Meier method.

Results: Among 176 total patients, 138 met inclusion criteria. Most were Caucasian (77%) and female (99%), with a median age of 40 (IQR 32, 49). Most tumors were high grade (39%) at presentation, with a median size of 6.5 cm (IQR 4.5, 9.6). All patients underwent surgical resection with most undergoing mastectomy (88%). Axillary nodal surgery was undertaken in 37% of patients, with only 4% having nodal metastases. There were 121 patients (88%) who received multimodal treatment: chemotherapy + surgery (n=46, 38%), radiation therapy (RT) + surgery (n=15, 12%), or chemotherapy + RT + surgery (n=60, 50%). Median OS was 6 years (IQR 3.5, 8.7) with a 5-year OS of 58%. Sixty-two percent of patients experienced disease recurrence with a median RFS of 3 years (IQR 1.4, 7.7) and a 5-year RFS of 33%. Most recurrences were distant (79%) and occurred at multiple sites. Tumor size >5cm and high-grade pathology were independently associated with lower OS. When stratified by treatment modality, there was no statistical difference in OS (p=0.475).

Conclusions: Primary breast angiosarcoma arises in young women whereby large ( >5cm) and high-grade tumors portend worse survival outcomes. In this series, distant recurrence was common, and there were low rates of nodal metastases and local failure. Most patients received multimodal therapy with a combination of surgery, chemotherapy, and radiation without clear impact of modality on OS; however, further collaborative studies may be required to assess the impact of modality on disease outcomes.

Learning Objectives:

To better understand clinicopathologic features and treatment patterns among patients with primary breast angiosarcoma.
To better understand survival outcomes among patients with primary breast angiosarcoma.