Introduction
We have read with great interest the article “Primary and secondary breast angiosarcoma: single center report and a meta-analysis” published by Abdou et al. [1]. Firstly, we would like to congratulate the authors on this comprehensive article and huge experience. However, we would like to comment some facts concerning the surgical treatment of breast angiosarcoma.
Complete surgical excision with optimal margins is a cornerstone of surgical treatment in breast angiosarcoma patients. There are two surgical options: mastectomy and breast conserving surgery (BCS). Authors concluded that there were no statistically significant outcomes concerning recurrence-free survival or overall survival comparing mastectomy to BCS. In our opinion, BCS should be considered only in patients with breast angiosarcoma with small size tumors [2]. Besides, BCS is a rather challenging approach in the combination of big tumors and small- or medium-sized breasts. The average tumor size in this paper was 6.9 cm. Also, we would like to point out that the tumor grade is rather an important factor of an unfavorable prognosis. More than sixty percent of patients in this paper had a high tumor grade. Finally, unclear data regarding multifocality and a small number of patients should also be considered in making conclusions.
Further studies with a larger number of patients, using univariant and multivariant analysis, should be performed in order to achieve adequate conclusions [3].
References
Abdou Y, Elkhanany A, Attwood K, Ji W, Takabe K, Opyrchal M (2019) Primary and secondary breast angiosarcoma: single center report and a meta-analysis. Breast Cancer Res Treat 178(3):523–533
Taffurelli M, Pellegrini A, Meattini I et al (2019) Secondary breast angiosarcoma: a multicentre retrospective survey by the National Italian Association of Breast Surgeons (ANISC). Breast 45:56–60
McClelland S III, Hatfield J, Degnin C, Chen Y, Mitin T (2019) Extent of resection and role of adjuvant treatment in resected localized breast angiosarcoma. Breast Cancer Res Treat 175(2):409–418
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Zdravkovic, D., Granic, M. & Crnokrak, B. Proper treatment of breast angiosarcoma-mastectomy or breast conserving surgery?. Breast Cancer Res Treat 179, 765 (2020). https://doi.org/10.1007/s10549-019-05509-0
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DOI: https://doi.org/10.1007/s10549-019-05509-0