乳腺血管肉瘤的临床特征和预后分析

  目的  乳腺血管肉瘤是一种少见的、异质性的疾病，约占原发性乳腺癌的0.04%和乳腺肉瘤的8%。回顾性分析1975年10月至2009年6月天津医科大学肿瘤医院13例乳腺血管肉瘤患者的临床特征和预后。  方法  使用Kaplan-Meier方法统计分析不同肿物大小、肿物切缘状态及组织学分级对OS和DFS的影响。通过Log-rank单因素检测分析患者的预后。  结果  患者确诊时的中位和平均年龄分别为48岁和44岁。随访中位时间50（7~98）个月，所有患者均接受手术治疗，2例进行化疗，8例死于复发或转移。  结论  乳腺血管肉瘤预后极差，中位DFS和OS分别为28个月和45个月。肿瘤大小和手术切缘与预后密切相关（P < 0.05），组织学级别高的乳腺血管肉瘤存在OS较短特征（P>0.05），且具有较高的局部复发和转移的风险（P < 0.05）。 

Clinical features and prognostic analysis of breast angiosarcoma

  Objective   Angiosarcoma of the breast is a rare and heterogeneous entity and its overall incidence is reported as 0.04% of primary breast cancer and as 8% of breast sarcoma approximately. To retrospectively analyze the clinical features and prognosis of breast angiosarcoma, 13 patients were identified by mammary pathologists in Tianjin Medical University Cancer Institute and Hospital from October 1975 to June 2009.  Methods   Kaplan-Meier method was carried out to analyze different tumor size, tumor margins and histological grade. Prognosis was tested with univariate analysis by Log-rank test.  Results   Median and mean age at diagnosis were 48 years and 44 years, respectively. The duration of follow-up ranged from 7 to 98 months (median, 50 months). All patients underwent surgical excision. Two patients received chemotherapy. Eight patients succumbed to recurrence and distant metastasis.  Conclusion   Angiosarcoma of the breast has an exceedingly poor prognosis. The median disease-free survival (DFS) and overall survival (OS) were 28 months and 45 months, respectively. Both tumor size and surgical margins were associated with prognosis (P < 0.05). Patients with high histological grade had a tendency of short OS (P>0.05) and a high risk of recurrence and metastasis (P < 0.05).